Transcript:

Adam Siladi: Welcome, everybody, to this special edition of the eClinicalWorks Podcast, here at the National Conference in Dallas, Texas. My name is Adam Siladi, and I’m here speaking with Josie van Scholten from River Road Medical Group in Oregon. Welcome, Josie!

Josie: It’s not. This is my sixth!

Adam: What keeps you coming back to the National Conference?

Josie: There’s always something new to learn. I always like to see the Showcase, what are the new products are that are coming out, so I can start thinking about how I want to implement that in the clinic, how I want to use it. We always bring several people from our office, because it’s a great bonding time, a great time for them to learn, and a great time to have fun.

Adam: It’s great that you involve the whole team. And now, you’re not only here to learn, you’re also here to share a little bit of your knowledge and expertise, isn’t that right? You have a presentation coming up?

Josie: I do. Megan and I are presenting tomorrow at 11:30. I kind of thought about this for a while. It’s a little bit intimidating to do, but some of my favorite sessions every year are the ones done by clients, just because, again, you get to see how they are using the system, what their ideas are, and how you might incorporate those into your own practice. So, we certainly don’t have all the answers, but I figured it was our turn to stand up and give some ideas and keep the conversation going.

Adam: Well, that’s the power of a network, right? Sharing ideas, and learning from each other, and improving together, right? Just like eClinicalWorks and our clients try to improve healthcare together, you’re doing the same thing. So, tell us a little bit about what people who aren’t here at the Conference could expect from your presentation.

Josie: So, our presentation is Patient Engagement strategies to help transform your organization. We are a primary care office, so we are in the thick of trying to meet quality measures and we’ve gotten pretty good at earning some bonus funds from our Medicaid and our Medicare programs. And you can’t do that without patients participating. There’s no way, you can’t wait from them to come in. And so, we’re going to talk about some of our favorite tools in eCW to communicate with our patients.

Adam: And that’s really one of the big pushes in a lot of these practice transformation ideas, that going from fee-for-service to value-based care. When you just start thinking of the patient when they’re not in front of us and ask the question well, who should be in front of us? And how can we help care for them? So, what are some of the things that you have been doing or learning on that road to value-based care?

Josie: Like I said, definitely you need to include the patient. We found the most effective way to involve and communicate with your patient is to sign them up for the healow app or the Patient Portal. In the beginning, it, quite frankly, is a lot of work. It’s an investment, because it takes a while until you hit that critical mass where you have the majority of your patient base signed up. And once you hit that mass, then it becomes a really powerful tool for staff members. Instead of picking up the phone, it’s like ‘Oh, I could just send a message, or send them a text message.’ It opens up a whole new world of ways to communicate.

Adam: And now that you have reached that critical mass, as you said, do you find that that becomes overwhelming? Is there too much communication going on? I know that’s a big concern with people, you know, we’re getting them on the Portal, and now all of a sudden, you know, instead of 20 phone calls, now we have 300 messages. Is that what you’ve found?

Josie: No, actually I think you’d probably need to ask our patients that question, because it’s always us saying ‘You need to come in! You’re due to come. It’s time for your Medicare wellness visit. We haven’t seen you!’ It’s really more the other way. I think some of them sometimes feel hassled, especially until they get dialed in. You know, sometimes you inadvertently send them the text, the Portal message, the phone call reminder.

Adam: Of course, we help you to track their preferences so that we’re not communicating with them in a way that they don’t want.

Josie: Four times!

Adam: Right, exactly! Now you’re mentioned — we’ve talked before — you were a member on one of our previous Podcasts. We came to visit you at your office, and you shared a little tidbit that I thought was very interesting when you were trying to get your patients on board with all of these initiatives, I think you actually brought in an intern from the local area to help you educate your patients. So, what did that intern do with your patients? How did they onboard them?

Josie: We had an intern just spend time in the waiting room, approaching patients and asking them if they would like to learn more about the portal or the app, and if they were using it, if they had questions, they could show them and explain to them some of the benefits.

Adam: Now, of course we’re talking about this in the context of a shift from fee-for-service to value-based care. I think a lot of the things that you’ve been talking about how been to bring the rest of your practice, and involving them as a care team, and also when we’re talking about that shift, you know, there might be come concern or some, I guess concern’s the best word, about what will happen to the operations side of the practice. You know, will we be able to survive this shift, and thrive through it? What have you found that transition to be like in terms of, let’s talk about keeping the lights on, for example.

Josie: When I first started down this path, I thought that fee-for-service would slowly decline and that fee-for-value, these bonus programs, would slowly cannibalize our fee-for-service income. And actually, it was interesting in preparing my slides that it’s really the opposite. They’re both going up together, and I think that that’s because a lot of the fee-for-value piece is done by staff. It’s a team-based approach. It’s not all dependent on the provider to get these pieces done. It’s our staff members who are calling and sending the messages, and looking in the CCMR, and trying to find patients who are due for things, and closing care gaps, and keeping track of where we are for those programs. That’s all work that staff does, and is a new source of income.

Adam: So, when we’re moving towards that team-based approach, it sounds like we’re removing that bottleneck that was ‘Let me get that provider into that room to see the patient directly and do all of the things that we need to do to get the reimbursement.’ Now it is being spread out, and people are recognizing the fact that you need to involve that care team. You were PCMH participant as well, and that’s a big push of that program, right, to bring people up to their highest level of participation in the practice.

Josie: Right. I think actually our providers have really liked it. I think when you first get eCW, it’s all about just trying to figure out how to use the system, and trying to get stuff in there. But now that we’ve learned how to get things in there in a structured format, that it’s usable, and people can find it — rather than relying on the patient, you know, ‘Did you get a flu shot?’ You may or may not get an honest answer. We have the data right there at our fingertips.

Adam: Now, another thing that we talked about when we came to visit you in Oregon, was the fact that you, I believe, had just brought on a new provider.

Josie: Yes.

Adam: And you were looking to use some of the Patient Engagement tools like Open Access scheduling through healow to help get them up to speed. Tell us a little bit about that, and how that’s been going for you.

Josie: That has actually been very successful for us. We’re a small clinic. We definitely don’t have the marketing budget that some of the larger, multi-specialty groups do, and so we have done some Google online advertisements, that if someone is searching in our area, with symptoms, our ad will come up, and it will take them to our website, and on our website there’s the widget for healow that they can click on and pick their appointment time, and get in. And actually, we have doubled the number of new patients per month with this strategy, so we’re pretty pleased.

Adam: That’s great to know. I know people sometimes are a little tentative in terms of whether they want to get on board with that, but it sounds like it’s working great for you. Another final aspect that I’d like to ask you about is, we’re talking about all this Patient Engagement, and one of the ways that we can engage our patients is to actually get feedback from them for how we are doing. I know you had done the CAPHS surveys with your practice as part of the PCMH initiative. Tell us about that.

Josie: Yeah, when we first started we did the old-school hand out the papers, you know. Staff wouldn’t necessarily want to hand them out to somebody who was upset. Not intentionally trying to skew our data, but not wanting to upset someone further. So, the automated system is much better. We’ve actually just sent a link, a Survey Monkey link out before through the Patient Portal blast, and been able to capture data that way. We also have used decision aids and other patient education links in our Portal blasts and campaigns as well, and found them to be effective.

Adam: That’s great. And as you mentioned, you’re using one method of doing it, using an outside tool, giving the patients that link through the Messenger tool, which is a great way to get that message out to a lot of people very quickly. And, of course, eClinicalWorks also offers our version of the CAPHS survey, and as you may or may not have seen during our Keynote, we unveiled a pretty cool feature this year, of a new patient survey tool that you can use with your Messenger campaigns.

Josie: That’s exciting.

Adam: So, hopefully we’ll see a lot of people using that in the future. Well, Josie, thank you very much as always. I wish you the best with your presentation.

Josie: Thank you.

Adam: This has been a great interview. For more eClinicalWorks Podcasts you can check us out on iTunes, YouTube, or my.eclinicalworks.com. For the eClinicalWorks Podcast, I’m Adam Siladi, thanks for joining us.