Community Health Center, Inc. is Connecticut’s largest healthcare provider committed to caring for uninsured and underserved populations. CHC is focused on improving health outcomes for its more than 145,000 patients as well as building healthy communities. It delivers service in over 200 locations statewide, offering primary care in medical, dental, and behavioral healthcare. To continue to be successful in serving their diverse patient population, they need to be able to effectively and efficiently communicate with patients, which was a challenge until they signed on with Solutionreach in 2019.
Engaging, effective patient communication is a challenge for any large, multi-site healthcare organization. CHC is no different. While their care is innovative, their patient communication was a patchwork. For appointment reminders, they used two different systems; one vendor sent text message reminders to some patients, while a second vendor did phone calls. Additionally, the bulk of their appointment reminders were sent by phone. In addition to poor reminder workflow, about 70 percent of CHC's patients are covered by Medicaid, a population with a higher no-show rate than those covered by commercial insurance. Finally, the reminder systems themselves simply weren’t reliable. “We would have stretches where text message reminders just wouldn’t be going out,” recalled Kate Gager, CHC Patient Experience Coordinator. “Our no-show rate was about 21 percent.”
CHC wanted a system that they could rely on to improve the reminder process, reduce no-shows, and increase confirmations. They chose Solutionreach for its ability to automate reminders through text, email, and phone. Owing to the fact that CHC has integrated medical, behavioral health, dental, and specialty services co-located at its clinics, it took CHC and Solutionreach staff over two months to get all 15 virtual locations built in the system, but it paid off. “Solutionreach is more reliable when it comes to sending our automated appointment reminders,” says Gager. “Our no-show rate is slowly but surely dropping.” Before the COVID-19 crisis, it had gone down from 21 percent to 17 percent. CHC was definitely headed in the right direction as they continued to fine tune.
Everything changed in March 2020 with the COVID-19 pandemic. “Around March 8, we started to see patients self-selecting to cancel,” explained Meredith Johnson, CHC Chief of Staff. “By March 13 schools were starting to close; on March 17 we trained our providers on Zoom and our telehealth workflows; and the following day (three business days after telehealth was approved in Connecticut) providers were seeing patients virtually. We went from 100 percent in-person visits to 96 percent of visits being conducted by video or phone in a couple short weeks. Suddenly, Solutionreach messaging was our communication lifeline to patients. It went from being a “nice to have” reminder system to the only way we could quickly get information out to patients about cancellations or changing in person visits to telehealth.”
CHC had a three-stage approach to patient outreach once COVID-19 started affecting appointments. First, they had to get immediate communication out that this was not the time to come into the office. “We had to say, as much as we want to see you and care about you, this is not the time to come in, but stay tuned as we’re rolling out telehealth,” says Johnson. “Then we had to introduce video appointments. These visits require us to communicate extra information to our patients, including how to prepare for and conduct their video visit, as well as provide the patient with Zoom meeting details needed to join the visit. Finally, Connecticut approved telephone appointments, so we sent reminders with instructions for those calls.
“In this post-COVID period, Solutionreach was the only way to find out about your visit information,” says Gager. “There wasn’t another way to get this much information out to this many people. We had to rely on Solutionreach and, as a result, we moved on some quick decisions with them to get things done.” For example, Solutionreach had been working on delivering an automated cancellation write-back tool since CHC went live. However, with CHC receiving mass cancellations, it was clear that process needed to be moved to the top of the priority list and automated quickly. Solutionreach’s engineers made it happen within four weeks. In the first days, it saved CHC about eight hours a day in manual appointment cancellations alone, and it is still saving about two hours a day as they no longer have to read text messages related to cancellations.
CHC also needed a way to get the Zoom instructions and appointment links to patients for their video visits. To do it correctly required adding a new appointment provider filter to Solutionreach’s pre-visit instructions feature. After re-prioritizing this ask, Solutionreach found a way to deliver virtual visit reminders with Zoom visit instructions.
CHC has also relied heavily on group messages, which is something they had not used much until COVID-19. “We have used the group messages to get information out to large groups of patients about COVID-19 and changes we are making,” says Gager. In March 2020 alone, they sent over 200,000 messages to patients with COVID-19 related information and appointment changes.
Given the numerous changes CHC has faced, one would expect missed appointments to rise during COVID-19, but the opposite has occurred. Due to their swift and successful implementation of telehealth services and utilizing Solutionreach’s communication platform, CHC’s no-show rate is currently nine percent, less than half of what it was pre-COVID.
“Getting to this point wasn’t perfect,” Gager explains. “We had some ups and downs executing this so quickly, but now the telehealth process is pretty effective. Solutionreach has been very reliable in getting the messages out.”
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