Adam Siladi: Welcome to this edition of the eClinicalWorks podcast, I’m Adam Siladi. When the COVID-19 crisis hit, many practices that had been dipping their toes into advanced practice capabilities were forced to make a rapid transition from on-site care to an online presence. One of the areas most affected by this change was the front office, and many practices recognize that a reinvention of the front office is necessary to succeed in today’s new reality. Here to speak with us about what role these online capabilities will play in the new normal as offices begin to reopen is Rakhee Langer, Vice President, healow. Rakhee, thanks so much for taking the time to be here with us.

Rakhee Langer: Thanks, Adam. Thanks, very good to be here

Adam Siladi: So Rakhee, let’s begin with a discussion of what has changed for the front office and what capabilities are practices realizing that they need?

Rakhee Langer: That’s a really good question, and it’s quite a realization that all of us are coming to. One of the biggest changes that we have noticed is, on the provider side and on the patient side, there is a need for efficiencies to come in and play a big role because there’s so many changes in how patients are, you know, even nervous to go see their doctor. So, the whole concept of online scheduling is playing a very big role at this time.

Adam Siladi: It seems like this is part of an overall shift to a digital front office and how that will play out I think is going to be very, very interesting. So, online appointment booking, you mentioned, how would this process work for a practice that is facing this new reality?

Rakhee Langer: This is a wonderful question because I think a lot of our doctors are really nervous whether their schedule is going to be flooded with patients just booking appointments. They are unsure how the experience is going to work for them and for their patients. But I think the software comes with very good capabilities of any form of customization, so they have a very good control on what they want to publish. So, if they decide to have, uh, you know Mondays and Wednesdays as maybe TeleVisits hours, they can do that so that they can only offer TeleVisits at that time. Or, they can actually say that if there is an open slot, go ahead and publish it. So, there is many different ways that they can set up that schedule so that a patient can see what is available to be booked online and can go ahead and book the appointments.

Adam Siladi: Now the booking of the visits is only one part of the process for the front office. Of course, another piece of this is that when patients do book their appointments, you know, they were used to showing up and, you know, maybe filling out some information. How is that information going to get collected now that patients aren’t going in face to face?

Rakhee Langer: So, the concept of being able to get the check in done ahead of time plays a big role. So, you know, whether it is a contactless check-in, how you make sure that their questionnaires that can be completed. So, there’s really, you know, from a TeleVisit standpoint or from an on-site visit. So, it could be either of them that the online schedule will be published in the patient can go ahead and book an appointment. If it is a TeleVisit, which continues to grow at this time because patients are still looking to be at home and if possible be seen on a TeleVisit, because that has proven to work out very well, the patient is given a list of questionnaires to complete. What are the symptoms? It could be specific to that, they can also pay their copay online so that the complete front office routine that was happening can be shifted online. Now, on the other hand, if it is an on-site visit and a patient has to actually be in the doctor’s office, they do have the option and go ahead and completing all of this through an online check-in. It is contactless, they don’t have to walk up to the front office, they can complete all their intake questionnaires, and they are ready to be seen by the doctor.

Adam Siladi: Yeah, and we did cover that contactless check-in process in more detail in another video, we’ll provide a link to that below in this particular interview. And, the online payments, you know, is a big component of that, you know, really making sure that the practice is collecting that revenue. At this time, I think is more important than ever as offices may be trying to rebuild their volume. Now, you know, Rakhee, you mentioned TeleVisits, which I think when we’re talking about scheduling is a pretty interesting topic. You know, a lot of offices I think are facing additional responsibilities and requirements between visits, you know, they might need to add an extra time for cleaning, they might want patients to not linger in the waiting room at the same time. How do TeleVisits fit into, you know, what practices may need to be doing to adjust for those things?

Rakhee Langer: That’s, you know, an interesting, you know, dilemma in a way for some of the practices. But I think they have definitely done a good job in spacing out the patients but also making sure that the technology that they have started utilizing, like TeleVisits, is something that can help in completely using the schedule for visits that can be done over TeleVisits. So, one of the interesting findings is the fact that there are services that can be offered very efficiently by the doctor over TeleVisits.

Adam Siladi: I heard there are some other exciting new capabilities that have been brought into that TeleVisit experience to make it more robust for the practice as well. Can you share some of those?

Rakhee Langer: So, screen sharing is a big feature that a lot of our doctors are looking forward to which we have actually rolled out. So, the customers are doctors can actually share education material, they can share their screen essentially, and have a conversation with the patient, very relevant in terms of what both of them are looking at so they can focus in, and discuss lab results, x-ray reports, growth charts, education, essentially everything on their screen so that they can share that with the patient. In addition, we also have the virtual waiting room where patients can actually go ahead and easily start a visit from let’s say a doctor’s website and wait for the doctor to join. And, like I mentioned a little earlier to be able to pay for the visit online right before starting the visit, makes it a lot more streamlined because that was the process that the patient was used to, the doctor’s office was used to. To be able to shift it all online is also a capability that has been rolled out.

Adam Siladi: I heard the use of trackers has also increased with this shift to telehealth. Can you talk a little bit about that?

Rakhee Langer: Absolutely, you know, the trackers is where a patient would be able to track all of their different, whether it’s weight or blood pressure, anything that they’ve either connected with the device or they are manually tracking it, it helps sort of present this data to the doctor as well. So, programs such as remote patient monitoring, and there are some value-based programs that some doctors are participating in, this helps to have that relevant conversation with the patient. Both of them are looking at the same thing, they’re able to see that the weight change for a CF patient, it has stayed where it should, the blood pressure for a hypertensive patient, either it is changing, or it is in control. Things like this become very relevant and helpful for both the provider and patient to look at. The access to that tracker data within the EHR is a very big deal, obviously, because the doctor can see that same information that the patient has been recording so they both are looking at the same data set.

Adam Siladi: You know, I think an interesting aspect of that is that those trackers can show the provider a trend of those regions overtime. So, it’s not just what is the reading right now at the time of the visit but what has it been in the past and is that showing some sort of a concerning trend. Of course, for patients and providers who are looking to acquire these tools, those are of course, linked directly inside the app so that they can open up that section of the healow app. Select the tracker that they would like and then order that directly from the manufacturer. Rakhee, these are all great capabilities that we’ve been talking about here. I think a lot of practices are going to be excited to make use of these, there’s certainly a lot of application these days more than ever. But what is on the horizon for healow? What are we going to be seeing coming out soon?

Rakhee Langer: You know, the online scheduling there would be a few more enhancements to make sure that it probably helps with any form of efficiencies on the online side of it for sure. On the TeleVisits side, you know, the nurse being able to start a visit on behalf of a doctor—that can help again as close to an onsite visit, make it online, because the entire process will help both the patient and the doctor, whether it was the nurse actually completing the histories and getting all that information prior to the doctor seeing the patient, that would be another feature rolling out fairly soon.

Adam Siladi: Well, that’s certainly exciting and will we also see the capabilities to add in other providers as well to the visit eventually?

Rakhee Langer: Yes, you know, that would be that would be where we’d like to go—group visits and being able to have some form of a counseling, nutrition counseling, nutritionists, and maybe even multiple providers. A group visit, essentially, with either many people on the patient side or on the doctor side—that would be something that, you know, we’d like to get that out too soon.

Adam Siladi: Well, Rakhee, we’re certainly looking forward to all of these upcoming features and of course many of the things that we discussed are available today. You can get those right now and if you’d like more information on any of the topics that we’ve covered here today you can check out my.eclinicalworks.com or reach out to your Strategic Account Manager. Or, Rakhee, perhaps there is an actual email or a contact method that you’d like to suggest for groups looking for these?

Rakhee Langer: The my.eclinicalworks.com works that you mentioned that works great because we make sure we put up all the information on our support portal so that all our customers can read up about it, learn about it, and reach out to us. So, that would be a great avenue for them to get all this information.

Adam Siladi: Glad to hear it. Well Rakhee, you thank you so much for taking the time to speak with us today it’s been a great conversation.

Rakhee Langer: Thank you, same here. Thank you so much, Adam.

Adam Siladi: Be sure to check out our other eClinicalWorks podcast episodes on iTunes, YouTube, and my.eclinicalworks.com. For the eClinicalWorks Podcast, I’m Adam Siladi and thanks for watching.

Adam Siladi: Welcome to this edition of the eClinicalWorks podcast, I’m Adam Siladi. As services begin to reopen around the country, physician offices may be eager to start seeing patients in person and return to some semblance of normal. But rather than revert to the old ways of operating, many offices realize that this presents a rare opportunity to reinvent their practice and take an evolutionary leap into the new normal. Here to speak with us today about how reopening may change and reshape the appointment process is Sidd Shah, Vice President healow. Sidd, thanks so much for being here today.

Sidd Shah: Thank you, Adam. Pleasure to be here.

Adam Siladi: Now Sidd, in March, April and May virtual visits, TeleVisits, really took off. Right, that became kind of the go to way to provide care to patients for many practices, but now that practices are starting to reopen, what is going to change from this point forward?

Sidd Shah: Adam, we’re in interesting times today, right? Businesses across every industry are struggling, but at the same time offering creative and innovative solution to kind of come out of this situation. Touch-free services, contact-free services is what everyone is trying to use in every industry. Healthcare is no different. We need to have the medical practices also offer that to their patients. As patients move from those virtual visit days to now coming back into the office, they need to be provided assurance that when I visit my office, visit the doctor’s office, I am going to be as safe as I was when I was doing this from home. And, we need to provide solutions in the hands of doctors’ offices and the medical staff to make this easy for their patients. And, that’s the reason why healow is here to offer a contactless check-in experience for doctors’ office and their patients

Adam Siladi: So, that’s a great point, you know, that the check-in process needs to fundamentally shift. So, why don’t we explore what that would look like? Let’s say a patient books their appointment, you know, either online through an on-demand appointment, or by calling the office. What is the process from that point forward going to look like?

Sidd Shah: Yeah, let me walk you through that process. Once you book an appointment, either through healow’s online capability or made a phone call to doctor’s office, now in the traditional way, you would be getting a reminder from the doctor’s office that you have an appointment that is upcoming, right? This could be in the form of a voice call that has been sent to you on your phone or, even better, sent to you through an SMS message. Most people today are looking at SMS in every aspect of life. Imagine receiving an SMS message a few days prior to your appointment, telling you that you have an upcoming appointment. But not only that, we have embedded in that SMS now a link to allow the patient to begin their check-in process. Once that link is clicked, you can say that I’m going to confirm that I’m going to be there for the appointment, or you can say I’m going to not be able to make it. But once you confirm your appointment, you have the ability to add this to your calendar and there’s a button to say check-in. That check-in button will allow you to do everything that you would do in the traditional way in the doctor’s office, and what are those? There are five different things that you typically do in the waiting room at the front office when you go to the office. First thing, you’re going to be able to update your personal information. Through this healow check-in option, you can update your phone number, your address if anything has changed. Second, validate your insurance information. If there’s already one in there in record, you can say yes, this looks good. Or, you can give a picture of your new insurance card to the doctor’s office. Third, any disclosure, HIPAA forms, that you need to fill you would accept and sign those. You can do that electronically. Fourth, you’re looking at your medical information, so if you’re a new patient and you think that you need to fill out to let the doctor know what histories you have, any updates to medications that you’re taking, any allergies you have—all that information you can validate and provide to the office. And, finally payments. You will pay your copay. We’ve made this available through healow Payment Services and as part of the check-in process you can pay your copay or any available balances that you have. Now, this is the process few days prior to the appointment, and imagine that you’ve completed your check-in. What happens in the day of the appointment? That is the other important piece. On the day of the appointment, we allow the patient to say that I have arrived to the office. So when you’re driving to the doctor’s office and you’ve reached the location, you can hit a button on that same link or the link that you receive an SMS that you received on the day of the appointment to say I have arrived to the office. By saying that, the doctor’s office now knows that you are here waiting in the parking lot and wait, we see. We will validate every information that you put in before for check-in, if all of it that is good, they will let you know and get you going with the physician. And, that experience is what we call the contactless check-in.

Adam Siladi: So, it sounds like there’s a lot of automation involved in that process. Getting those documents signed electronically, updating the insurance information, and I’m sure there’s a capability here to have patients fill out information ahead of the visit through questionnaires that have been published. And, that’s a lot of changes for both the practice and for the patients in this process. There’s a lot of things that are going to be shifting and adjusting. I’m sure there’s a lot of practices that are worried whether they’re doing it right and whether their patients are responding well to those changes. How would practices stay informed about their patient’s reactions to these adjustments?

Sidd Shah: Absolutely, feedback is important, right, and any change that you make we want that feedback to come back to the practices. What is the experience like? Did the patients like what they did? And that’s why Messenger has the capability to offer post-visit survey campaigns to the doctor’s offices. What this campaign does is right after your point after the appointment that very next day the patient will get a text message or an email asking for feedback. And that survey could be designed by the doctor’s office in with any number of questions they want, any type of questions they want, and that information then becomes available to the physician office in the form of one of those survey analytics, which they can, you know, kind of compare and contrast between patients, between physicians, between offices and make changes that are necessary in their office. So, we encourage our practices to use the post-visit survey campaign.

Adam Siladi: Now Sidd, how are practices going to be able to get ahold of these various capabilities?

Sidd Shah: We made it very easy and simple for them. Most practices today use the Messenger appointment reminder capabilities. What we ask is, if you’re not sending messages reminders through SMS, start doing that. And, we’ve given a simple ability for provider offices to enable the functionality of check-in. Once you enable that as part of the SMS, like I said, a link will go out to begin check-in and that information then flows right into the patients’ chart in the EMR. And so, there’s very little learning for the patient and there is very little learning for the doctor’s office—we’ve kept it very simple for them. So, start using appointment reminders through SMS and enable the begin check-in option.

Adam Siladi: Well Sidd, it sounds like this contactless check-in process is introducing a lot of automation to the appointment. Patients can complete forms and update insurance and I’m sure they can even go ahead and prefill some of the information in the appointment through questionnaires that might have been published for the visit. All of this sounds like it’s going to offload a lot of burden from some of the front office staff in the practice. What could practices be doing with those resources now that they might have some additional time to work with?

Sidd Shah: Yeah, it’s a good thing that they’ll have some more time now, right. The burden word you use is important that that’s taken off the shoulder of the medical staff, even slightly if not more. And, we encourage our offices, doctor’s offices, to use that time to let patients, educate the patients about the healow app, about the Patient Portal and get them to get web-enabled, get them online, get them access to their information online. The capabilities are there, we allow the patients to book online directly, we allow the patients to look at the health information, to update that information, to send messages to the doctor’s office electronically, to have the virtual visits—so many capabilities that healow has to offer. And if the doctor’s office can do a little more to educate the patients about that and the capabilities, I believe the patients will use that. And so, we feel that that time can be repurposed to that.

Adam Siladi: Well it sounds like certainly a great place to start, and if they’re already using those capabilities, it sounds like they’re going to be getting even better in the near future here. So, Sidd thank you so much for your time and your information here today—we do really appreciate it.

Sidd Shah: Absolutely, thank you Adam.

Adam Siladi: Now, for those of you who are watching, if you’d like to learn anything else about these tools and capabilities that we’ve discussed on today’s episode, you can reach out to your strategic account manager or you can find more information on my.eclinicalworks.com. You can also check out our other eClinicalWorks podcasts on iTunes, YouTube, and my.eclinicalworks.com. For the eClinicalWorks podcast, I’m Adam Siladi. Thanks for watching.

Adam Siladi: Welcome to this edition of the eClinicalWorks podcast. I’m Adam Siladi. The COVID-19 crisis has forced many practices to rethink how they deliver patient care, seeing the need to reinvent the pre-visit process from booking appointments online and contactless check-in to the visit itself with telehealth and integrated speech. But the period following the visit can be just as vital to patient health and practice success. Is it time to reinvent the post-visit process? Here to speak with me today is Hussein Elhaj, Business Development at eClinicalWorks. Hussein, thank you so much for taking your time to be here today.

Hussein Elhaj: My pleasure. Thank you so much for having me, Adam.

Adam Siladi: Well, Hussein, let’s start with the question: What is the post-visit and what are we really reinventing here?

Hussein Elhaj: Sure. So, this is a very good question. Um, it’s no secret that we are in a very dynamic, rapidly changing industry. So, the question becomes: what happens when the patient leaves the walls of the clinic? What if these patients have chronic conditions, right? What if they have to be hospitalized for chronic conditions? And then, of course, introduced equation, a global pandemic that really has an effect on everybody. The COVID-19 pandemic has made it absolutely clear that we can no longer limit patient care to the walls of the clinics, and we really must extend it outside of these walls. So, we felt that a post-visit engagement strategy is absolutely essential, especially now more than ever. And while it’s been a topic of discussion for organizations in the past, I think it’s been thrusted to the forefront at this particular point. And we know for it to be successful it really has to provide a level of convenience, not just for the patients. We know it has to be convenient for the patient, but it also has to provide that level of convenience for organizations as well by minimizing as much as possible manual processes and allowing practices to track progress.

Adam Siladi: What are some of the components of that post-visit strategy that you mentioned? What do practices — what are they going to need to focus on if they’re thinking about this, this reinvention?

Hussein Elhaj: Sure, absolutely. So, it definitely has to be a multi-pronged approach. So, first of all, you know there is to a certain extent some level of engagement with the patient, but that process has to be improved, and there’s two major parts to this equation, right? There’s the clinician. And then there’s the patient. Both play an important role, and it’s important that the patient has as much of a vested interest in the outcomes of their own health as the clinicians, so how do we improve the process? First of all, it’s maintaining a frequent communication with the patient, empowering the patient with information that is accessible to them. And when I say accessible, it’s got to be conveniently accessible to the patient. Now, in addition to that, we may have some patients that are extremely high risk, and we do have to have as an organization a targeted outreach strategy, as well. The last and the most important thing is, how can a practice extend their services outside of those walls, provide the appropriate care for the patient, and then find ways to get reimbursed for that care as well?

Adam Siladi: Alright Hussein, let’s start with the first topic that you mentioned, which was engagement. You know, I think a lot of offices are busier than ever. They have additional responsibilities and concerns at this time. What are those busy practices going to do to stay engaged with their patients while they have all these other things to think about?

Hussein Elhaj: Uh, absolutely, very good question. And of course, the convenience has to be presented on both sides as I made the point a little bit earlier and I think one of the best ways to do so by empowering the patient is the use of the healow app. You know, everybody walks around with a smartphone in their hand. And if all I have to do to log into my app is, you know, do my touch ID and I have access to all my information, right, things like post-visit summary, labs information, patient education, referrals. I am now empowered as a patient and I can take a vested interest and if I need to reach out to my provider, I could do it directly from the healow app. It is secured, it is encrypted and that clinicians would be able to respond in time. The majority of our population has a smartphone and we found especially these days that even older patients have been utilizing it.

Adam Siladi: Now Hussein, the healow app certainly provides a lot of convenience and information to the patient in terms of visit summaries, lab results, prescription notifications, etc. But what about information going the other way? If we’re getting these patients more engaged in reinventing this post-visit process, what are practices going to know about their patients that they might not have known before?

Hussein Elhaj: Um, excellent question. So, the great thing about the healow app is the patient’s ability to integrate, to integrate wearables and tracking devices directly with the healow app. And there’s a plethora of different devices that the healow app supports. There’s many different kinds of trackers that integrate information directly with the healow app and what’s great about it, is that at the point of care the provider has the ability to access the healow Hub and view this tracker information directly within the Progress Note. This can provide significant information and help the provider make appropriate medical decisions and put together an appropriate plan of care for that patient.

Adam Siladi: Hussein, you also mentioned the need to do outreach to these patients is in-between visits. What kind of outreach are we talking about and how would that happen in this reinvented process?

Hussein Elhaj: Absolutely. So, eCW has you utilizing Messenger. In eCW we have 50+ campaigns that practices can enable to determine which population of patients they want to outreach to and within these Messenger campaigns we have different categories of campaigns. So, this outreach could be administrative in nature. Let’s say you want to reach out to patients that have not had their annual wellness visit this year — and we know statistics clearly show that only about 25% of patients actually come for an annual wellness visit. So, we know that there’s a big gap over there and that’s one way to help close the gap. So, these campaigns allow you to identify the subset of patients that have chronic conditions that may be require more intervention, a higher level of patient engagement, and when you set the parameters for these campaigns, you can determine essentially what modalities these messages go to.

Adam Siladi: You know, Hussein, I think one of the other important campaigns that’s out there is that no-show campaign, right? Missed appointments is missed revenue for practices and right now that’s more important than ever. So that campaign, which will communicate automatically with those patients who didn’t show up for their visit and then allow them to rebook their appointment, I think, is a critical piece in this reinvention of the post-visit. And speaking of services. we mentioned the need to expand services at this time. Where is there an opportunity to add services with these practices who are already busy enough?

Hussein Elhaj: Absolutely. So, you know, as we talked about, you know, adding these services is going to require the utilization of resources from the practice side. So, practices may tell you we just don’t have the capacity. We don’t have the time. There’s a cost associated with it. Now, what practices may not know is there are programs out there — some of which have been recently introduced and some that have been out for numerous years — that will reimburse you for engaging those patients. So, there is the CCM program the Chronic Care Management program which was introduced by CMS these are for your Medicare and Medicare Advantage patients back in 2015. And historically, some of the hindrances for that program was the fact that in the past patients had to pay a co-insurance or copay because of COVID-19. CMS basically said we are waiving copays for patients. So, this is an absolute great opportunity for practices to take advantage of this and sign patients up if you have Medicare age patients.

Adam Siladi: What about patients who do wind up in the hospital, Hussein? What are we doing to manage those patients in-between visits?

Hussein Elhaj: Absolutely, very good question. So, just to take a step back, the purpose of the Chronic Care Management program is to try as much as possible to prevent hospital visits, right? Now if it gets to the point where the patient does have a hospital visit, there’s also a Transition of Care Management program that is available from CMS as well. And with this program, when a patient has been discharged from an acute care visit, whether it was for COVID-19 or for lack of management of their other chronic conditions, be it diabetes or hypertension. The goal is to as much as possible prevent the readmission to the hospital within 30 days. The transition of care program will essentially allow you to track once that patient has been discharged from a hospital. The first thing the hospital is going to do is contact the primary care physician and say this patient has been discharged. This is going to be done whether it’s done through fax or through an email or through a phone call, or they may even provide an Excel file and say this is a list of patients that have been discharged from the hospital, right? So, you have the ability to upload that information into the dashboard and then track your engagement with the patient post-discharge to ensure that you are hitting the appropriate milestones.

Adam Siladi: But how are practices going to get any insights into what patients’ reactions are to all of these new features, new capabilities, and new services?

Hussein Elhaj: Practices should definitely have insight as to how satisfied patients are with the various services that are being provided to them. And we do have a post-visit survey that will allow practices to get the appropriate insight. Now that post-visit survey can be customized to the practice’s need. We call this the Net Promoter score, which is part of that post-visit survey. So, you will have insight into your Net Promoter score, which will let you know how well you’re doing as a practice and where do you need to realign your resources to ensure that you’re providing proper customer service to these patients?

Adam Siladi: Well, certainly a very valuable way too. Gain insights, it’s convenient. As you mentioned before, all of these things need to be convenient for the practice and for the patients. And you know, with those out-of-the-box templates for your post-visit questionnaires as well as ways to basically build your own as like a drag-and-drop kind of model. They’re very, very useful, very handy for practices to stay in touch with their patients and get a pulse of what their reactions were. Hussein, I’d like to thank you so much for your time here today. We really appreciate it, having you on the eClinicalWorks podcast.

Hussein Elhaj: It’s been my pleasure. Thank you so much for having me Adam.

Adam Siladi: Well, you can check out our other eClinicalWorks podcast episodes on iTunes, YouTube, and my.eclinicalworks.com. And if you have any questions about things that you’ve heard or seen here today, you can get in touch with your Strategic Account Manager or check out my.eclinicalworks.com for more information. For the eClinicalWorks podcast, I’m Adam Siladi and thanks for watching.