I’ve referenced Dave Chase before in our blog. While his company Avado is in the business of modernizing patient communication, he is a thoughtful commentator on the future of care beyond the confines of his business, especially the future faced by physicians and their patients.
One of the concerns we’ve heard for years is that giving out your e-mail will lead to enormous and unproductive time responding to a flood of patient messages. Chase, in a recent post on his Forbes blog, is only the latest person to disagree.
He’s been doing research on patient-provider communication for an upcoming book. It’s timely to investigate this area with the impending Stage 2 Meaningful Use rules, which mandate heightened patient engagement, and he notes that e-mail access is more efficient for a practice and can lead to better outcomes. Here’s what an orthopedic surgeon has to say in the article:
“Physicians underestimate the fact that opening up a digital channel to facilitate post-visit, post-surgery, etc. comments and questions can and does provide a very real ROI if you dive into the typical workflow pattern that evolves when a patient calls with questions.”
Exactly. One quick e-mail, when it’s appropriate, compared to staff playing phone tag. And all the evidence points to the fact that patients don’t abuse their e-mail access.
Clearly, using e-mail as an effective communication and engagement tool is more than simply handing out the address. It will take practice to learn how to e-mail efficiently (a response shouldn’t always take 15 minutes) and staff will need to learn how to separate urgent issues that should be responded to in-person or at least immediately from ones that can, say, be responded to in batches at the end of the day. However, the effort to integrate new communications tools into the working life of the practice is worth it. Chase notes how some innovative practices have begun to develop automated messages that go well beyond the appointment reminder, encouraging patients to initiate follow up via e-mail, a real time saver that also happens to increase compliance.
One area where I diverge a bit from Chase is his assertion that a switch to outcomes-based compensation is essential to the more connected physician-patient relationship. He’s right that current payment models don’t often allow for this new channel, but waiting for the entire payment regime to evolve will take too long. While the “gateway drug” analogy he uses may strike some as unfortunate, I like the idea that patients not simply accept but get addicted to the simplicity and ease of e-mail communication. The Hello Health business model of New Revenue™ is based upon the idea that patients will in fact gladly pay a small monthly sum for the kind of access Chase refers to, because of the value they experience. This is already proving itself in current practices on the Hello Health platform.
“Laying on of hands” remains a central part of the physician-patient relationship, but not all the time, and not for everything. E-mail is the first step, providing a much richer online environment through a portal like we have with Hello Health, and in helping patients feel connected and respected between the in-office appointment. It’s also the first step in helping a practice care for its population, not just the patients who walk in the door. With a model like ours, a practice will find it won’t need the incentives of the next stages of Meaningful Use or outcomes-based pay to uncover the worth of truly engaging its patients.
Steven Ferguson is the patient management officer at Hello Health, the revenue generating EHR platform for primary care practices supporting practice vitality through patient engagement and electronic medical revenue.