Patient Expectations for Modern Medical Practices (Pt. 1): Patient Outreach

By: on November 8, 2016

Patients are losing patience with the way many doctors’ offices have traditionally operated: long wait times, limited contact with the physician, little to no access to their medical records.

Modern medical practices are working to reverse these stereotypes, and so should you, lest you lose patients to another practice. It’s more likely than you may think:

One in ten patients consider switching doctors

Source: Vanderbilt University Center for Patient and Professional Advocacy

The good news is, there are steps you can take to avoid disappointing your current patients while also attracting new ones.

In this three-part series, we’ll explain how to meet and exceed different sets of patient expectations to keep your practice thriving.

These expectations are inspired, in part, by insights found in Gartner’s Business Drivers for Healthcare Provider Information Technology Decisions, 2016. (This report is available to Gartner clients.)

According to the authors, “An increasingly connected and sophisticated consumer of health care services is emerging with expectations of participation in health care decisions and access to an expanding array of online information and real-time support.”

That’s why we’re focusing the first part of our article series on patient outreach strategies.

Keep reading for expert analysis from patient engagement advocate Dave deBronkart, examples of helpful software tools and best practices for delivering excellent care.

Why Modern Medical Practices Value Patient Outreach

One of my takeaways from the Gartner report cited above is that we’re witnessing the rise of a patient-centered movement. Dave deBronkart is on the front lines of that movement.

After beating late-stage kidney cancer, he became known as “e-Patient Dave”—a speaker, activist and author working to open health information access to patients.

“In my view the ideal medical practice today does—and all will, someday—recognize patients as strong potential contributors to health and care. Patient perspectives will be welcomed, and patient competence will be encouraged, recognized and developed.”

''e-Patient Dave'' deBronkart, patient advocate and activist

Photo credit: Kern Photo

He says most patients aren’t thinking this way just yet, since what’s happening here is nothing short of a culture change. Nevertheless, there are signs that deBronkart’s vision will soon be the norm.

In a 2013 study, for example, the Medical Group Management Association (MGMA) discovered that almost 80 percent of practices they identified as “better-performing” used patient satisfaction surveys.

While there is some debate about the efficacy of these surveys, it’s significant that payers and providers are paying more attention to the patient experience.

Health insurance companies and the government are already using patient satisfaction scores to evaluate provider performance. In many cases, those scores impact physician payments.

The idea is that satisfied patients have better outcomes in their care cycle:


The Impact of Patient Satisfaction


Source: Physician’s Practice
So how do you ensure patients are satisfied and successful? The three best practices for patient outreach below should make a big difference as you modernize your approach to health care.

Best Practice 1: Secure Messaging

If the only way for patients to reach your office is through the phone, it’s time to expand your offerings. Many people prefer communicating electronically to having in-person or phone conversations.

You may find your staff prefers this too, since it’s often easier to respond to queries digitally instead of fielding multiple phone calls.

By giving patients more convenient opportunities to interact with you, you’re increasing the chances they’ll reach out with questions or concerns about their treatment plans.

It also makes it faster and more cost-effective to share their health records because you don’t have to worry about making paper copies or paying for postage.

How can small practices achieve this best practice?

One way to electronically exchange messages and clinical information with patients is to implement a patient portal. This is a secure website commonly integrated with electronic health records (EHR) systems that gives patients 24-hour access to services, messages and information from their care team.

We’ve written extensively on why patient portals are great—they’re usually HIPAA-compliant, allow patients to request prescription refills and improve health outcomes, among other benefits.

An example of a patient portal interface. Source: iSalus EHR

However, if you’re not quite ready to buy special software, you can still exchange digital messages with your patients through email. This method may not be as centralized and manageable as a portal, but some patients are more comfortable with email and therefore more likely to use it regularly to connect with you.

“My colleagues and I do not want to be limited to HIPAA-compliant portals. In fact, OCR issued a statement last year that if I say I want information via plain old email, that’s fine!” says deBronkart.

“This is really important because many clinicians have been bamboozled into thinking that they can get stuck with HIPAA fines if they do something I want them to—not true! They only get fined if they leak my information to someone else.”

For more detailed information on privacy and security considerations when emailing (or texting) patients, click here.

Bottom line: If you’re serious about patient outreach, you need to explore digital forms of communication, as they are generally more convenient for both patient and provider.

Best Practice 2: Shared Decision-Making

The second patient outreach strategy we’ll discuss is shared decision-making (SDM). This is a type of collaborative care where doctors and patients work together to decide on the best treatment option.

SDM is best implemented in cases where there are several medically acceptable treatment options, and the patient has an opportunity to weigh the pros and cons of each one with you before making a final decision.

For example, comparing birth control options based on a patient’s preferences and lifestyle. (These are often referred to as “preference sensitive” treatment decisions.)

Last year, Software Advice surveyed U.S. patients on how they’d like to make treatment decisions, in the event that they are ill or injured and there is more than one medically reasonable treatment available.

A combined 68 percent say they would prefer to decide on treatment collaboratively, along with their physician.


Preferred Method for Making Treatment Decision


Preferred Method for Making Treatment Decision

There’s clearly a high level of demand for SDM, which indicates patients will come to expect it more as they interact with more forward-thinking physicians.

“A few doctors still think it’s absurd to ask patients their preferences, because they were taught that it’s the doctor’s job to know what’s good for the patient,” says deBronkart.

He explains that this outdated mentality is part of the cultural shift that is taking place. Increasingly, health care thought leaders and advocates are proving that patient input can have a positive impact on care quality. Patients can contribute in meaningful ways, such as:

  • Correcting errors in their own medical histories
  • Choosing treatments they are more likely to adhere to, because their outcome measures are more inspiring or attractive to them as individuals
  • Becoming more informed about their health condition(s)

How can small practices achieve this best practice?

The Mayo Clinic offers free patient decision aids and other resources to kickstart your SDM efforts. Of course, some patients may be more interested in SDM than others. That’s to be expected.

If you’d like to introduce collaborative care to modernize your practice but aren’t sure whether a patient will be into it, deBronkart recommends using the Patient Activation Measure (PAM).

The PAM is an assessment created by a team of researchers led by Dr. Judy Hibbard and licensed by Insignia Health that measures how “activated” a patient is on a scale of one to four. It helps physicians understand how to interact with patients to help move them up the ladder of activation.


Source: Insignia Health

“Activation level correlates with all kinds of clinical improvements, including, in one recent study, costs,” says deBronkart, citing research by Hibbard and others in this field. “Its usefulness is far broader than medical decision making.”

This is significant because one of the challenges of employing SDM is that there’s limited reimbursement for it, even though it sometimes requires additional time and effort on the physician’s part.

Bottom line: Patients are already hoping to play a larger role in the decision-making process when it comes to their own care plans, so it’s a matter of time before collaborative care models like SDM become an expectation rather than a rarity.

Best Practice 3: Education and Support Resources

We mentioned earlier that one of the benefits of modernizing your medical practice is retaining and attracting patients. That certainly applies to our final patient outreach strategy: providing resources for medical education and support.

In a Software Advice survey of U.S. chiropractic patients, a combined 91 percent told us they would be more likely to choose a chiropractor who uses multimedia educational materials (e.g., videos and digital images) in their practice over a similar chiropractor who did not.

Likelihood to Favor Chiropractor Using Educational Materials

Example of an material from ChiroTouch’s patient portal

Having resources at the ready to will help ensure they’re getting information about their diagnosis from a reliable source.

How can small practices achieve this best practice?

Many medical software solutions offer a library of patient education materials that address different conditions and treatments. However, if there’s no room in the budget for something like that, you can still have an open and productive conversation to help patients learn about what they’re going through and correct any misinformation.

After all, the Pew Research Center says 61 percent of American adults use a smartphone or tablet to research medical conditions and some websites out there are bound to be a little sketchy.

“My primary care physician Dr. Danny Sands breaks the ice on this by asking patients, ‘Are there any websites you’ve found useful?’ It immediately opens a dialogue and lets the doctor know what the patient values,” says deBronkart.

Sharing information about online patient networks and support groups is also a great way to help. Here are some free resources you can share with patients today:

  • CenterWatch: This is a list of health-related communities and blogs covering specific conditions (e.g., a support community for families affected by Nephrotic Syndrome, a discussion group about children with heart disease.)
    • Epocrates medical information: An athenahealth company with downloadable educational materials, such as illustrated handouts broken down by category (e.g., infectious diseases, cardiovascular).
      • Center for Disease Control (CDC) Fact Sheets: Some of the handouts included here are also available in Spanish.
      Bottom line: Providing patient education and support resources are a way for modern medical practices to keep people well informed and satisfied with a practice’s care quality.

      Next Steps

      All the patient outreach strategies highlighted in this article can help build the kind of modern medical practice patients will soon come to expect. This table shows how the expectations outlined by Gartner analysts relate to our proposed outreach strategies:

      Patient expectation Outreach strategy
      Participation in health care decisions Shared decision-making
      Access to an expanding array of online information Education and support resources
      Access to real-time support Secure messaging

      Contact us at (844) 686-5616 for more information on the tech solutions we offered to achieve these goals, such as patient portals and multimedia educational materials.

      And remember, this is just part one of our series on patient expectations. Sign up for our newsletter so you can get part two delivered straight to your inbox.

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