a better patient intake process · vwv i vÞ> ` «À ÛiÌ i*>Ì i Ì Ý«iÀ i vi 2 i n...

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A Better Patient Intake ProcessDrive Operational Efficiency and Improve the Patient Experience

SHAREA Better Patient Intake Process Drive Operational Efficiency and Improve the Patient Experience 2

I n todayrsquos data- and efficiency-driven healthcare environment a paper intake process poses significant challenges for organizations and patients alike The fundamental challenge

for healthcare organizations is that it increases operational burden while decreasing data quality This is counterintuitive When organizations devote time and resources to managing the intake process they should expect accurate and actionable data Instead staff often spend several hours a day entering handwritten information into the electronic health record (EHR) This laborious task distracts them from patient-focused responsibilities and it also increases the likelihood of costly errors during manual data entry

Another challenge is that data remains buried in paper documentsmdashand unviewed by physiciansmdash

until someone enters it into the EHR This is information that could be extremely valuable to physicians and help them prepare to meet with each patient In addition there are costs associated with the paper itself This includes the cost to mail paper forms prior to appointments that patients ultimately donrsquot complete It also includes the cost to scan and shred paper that contains protected health information

For patients todayrsquos intake process is time-consuming and frustrating Organizations often ask patients to fill out the same forms repeatedly and paper-processes tend to increase wait times leading to patient dissatisfaction A staggering 76 percent of health systems report low patient satisfaction with their intake experience according to a proprietary Tonic patient intake survey conducted in May 2018


WHERE lsquoINNOVATIONrsquo AND lsquoINTAKErsquo COLLIDEThe EHR revolution has prompted many organizations to re-evaluate their current intake process and begin the journey toward a more mobile-based approach to patient data collection In fact 87 percent of providers say streamlining the patient intake process is a top organizational priority according to the 2018 Tonic intake survey

Revamping the intake processmdashand lsquogoing mobilersquomdashmakes sense given the fact that 77 percent of Americans now own a smartphone according to the Pew Research Center Approximately 25 of US adults say they are lsquoalmost alwaysrsquo online according to a Pew Research Center survey conducted in January 2018 Even older generations have joined the smartphone revolution Sixty-seven percent of those ages 54 to 72 own a smartphone and 54 percent own a tablet computer according to the Pew Research Center Thirty percent of those ages 73 and older use a smartphone and 25 percent own a tablet computer

However the shift from paper to a mobile intake process doesnrsquot happen overnight As with any major process

change small steps are necessary to reach the ultimate goal Most commonly organizations begin with a mix of paper and electronic (eg providing an electronic intake but requiring patients to sign paper forms) Once organizations have taken this intermediary step they move on to what can be described most aptly as a lsquomobile intake processrsquomdashthat is an intake process

thatrsquos completely paperless consumer-focused and able to drive efficiencies EHRs provide some of this functionality natively (though their process is more portal driven than mobile driven) and there are also third-party systems that organizations can integrate with their EHR for this purpose

A mobile intake process helps organizations achieve operational efficiencies while also catering to patient preferences In particular it provides a mobile check-in thatrsquos similar to what consumers experience in other industries (eg airline hotel and restaurant) Consumers also want an intuitive user design that accommodates different health literacy and education levels all without requiring cumbersome usernames password and log-ins

ldquoThe majority of patients want a streamlined interaction that can only happen when yoursquore using some sort of digital data intake processrdquo says Adam Henick managing partner New World Health LLC a health and wellness venture capital company in New York City ldquoThis includes millennials generation X baby boomers and even seniors many of whom are either increasingly open to mobile intakes themselves or who have caretakers who prefer mobile intakesrdquo he adds

3 KEYS FOR PATIENT-DRIVEN INTAKE

1 Convenient No apps to download no usernames and passwords to remember

2 Consumer-centric Patients prefer engaging experiences using their everyday technology

3 Considerate Patients want to be remembered not answer the same questions at each visit

ldquoThe majority of patients want a streamlined interaction that can only happen when yoursquore

using some sort of digital data intake processrdquo -Adam Henick managing partner New World Health LLC


The mobile intake process is part of a larger movement toward healthcare consumerismmdashthat is the idea that patients have a choice as to where they receive care Competitive providers want to make the patient experience as pleasant and streamlined as possible A mobile intake process is just one of many ways to do this Others include patient portals check-in kiosks and even free Wi-Fi and device charging stations in the waiting areas Forty-nine percent of provider executives say revamping the patient experience is one of their organizationrsquos top three priorities over the next five years according to PwCrsquos annual report on the top health industry issues of 2018

Patients benefit from a mobile intake process because this intake saves time Long gone are the days in which patients receive a clipboard with a stack of paper forms to quickly fill out before a medical assistant or nurse calls their name to go into an exam room A mobile intake process prompts patients to complete forms in advance often significantly reducing patient wait times or even eliminating the wait entirely

For example at MedStar Health a system that switched from a paper intake process to a mobile intake process four years ago patients are often placed in an exam room as soon as they arrive ldquoWersquore able to take them right awaymdasheven when theyrsquore earlyrdquo says Pete Celano director of consumer health initiatives After implementing a mobile intake process the health system now receives a nine-out-of-10 patient satisfaction rating

Research data seems to support patient preference for mobile intake processes According to one recent study patients overwhelmingly preferred to complete questionnaires using a tablet rather than paper In another study the majority of patients felt that tablet-based questionnaires collected a more complete and accurate representation of their status and needs

A mobile intake process benefits healthcare organization in a variety of ways Consider the following

1 Eases the burden on clinicians Eighty-eight percent of physicians say patient history data is a priority but only 30 percent said they have access to that information according to the 2018 Physician Perspectives

on Access to Patient Data published by Surescripts Fifty percent of physicians want better access to patient data overall A mobile intake process provides clinicians with timely access to patient data that helps them make more informed clinical decisions

ldquoClinicians like having access to clinical data before they meet with the patient They can cut to the chase more quickly A mobile intake process makes them more efficient and able to see more patientsrdquo says Celano

5 BENEFITS OF A MOBILE INTAKE PROCESS

1 Decreases administrative burden

2 Enhances patient satisfaction

3 Improves outcomes

4 Increases revenue

5 Reduces clinician burnout

ldquoPhysicians like having access to clinical data before they meet with the patient They can cut to the chase more quickly A mobile intake process makes them more efficient and able to see more patientsrdquo -Pete Celano director consumer health initiatives MedStar Health


In some cases access to this data prevents clinicians from having to ask initial questions about the reason for the visit that often lead to detours in the conversation and quickly drain a physicianrsquos productivity says Celano

ldquoA mobile intake process allows us to surface key data from the patient to the provider in advance of the appointment allowing for a swifter dive into deep discussions with the patient during the appointmentrdquo he adds

2 Drives additional revenue Consumer attraction and retention equals more appointments equals more revenue A mobile intake process also helps organizations collect on patient balances that might otherwise go unpaid

3 Supports operational efficiencies With a paper intake process 41 percent of staff spend at least 24 minutes per intake according to the 2018 Tonic patient intake survey Twenty-nine percent spent more than 36 minutes per intake Fifty-eight percent of providers say this burden on staff is their biggest pain point

With a mobile intake process staff spend less time on manual data entry and more time on higher-

ldquoA mobile intake process allows us to surface key data from the patient to the provider in advance of the appointment allowing for a swifter dive into deep discussions with the

patient during the appointmentrdquo -Pete Celano director consumer health initiatives MedStar Health


value tasks to create a better patient experience At a fully-staffed clinic this time savings can equal up to one full-time receptionist At MedStar Health a mobile intake process helps staff save an average of 25 minutes checking in each new patient since therersquos no paperwork to complete and any potential care issues (eg a potential health risk or behavioral health issue) can be triaged ahead of time

4 Reduces errors Data errors occur frequently as front office staff multi-task while inputting data into the EHR A mobile intake process reduces these errors because data flow directly from the patient into the EHR Fewer errors in turn translate to fewer denials due to inaccurate name spellings transposed insurance identification numbers and more Therersquos also a dramatic increase in the collection of critical demographic data such as emergency contact information as well as clinical data such as allergies

5 Increases brand awareness A mobile intake process positions organizations as innovative and patient-focused creating a competitive advantage

6 Improves outcomes Patients tend to be more honest when theyrsquore able to answer questions digitally rather than face-to-face or even on a paper form that is circulated throughout the office says Celano This is especially true for questions about alcohol and drug use as well as depression and thoughts about suicide

At MedStar Health when patients check a box stating theyrsquove thought about taking their own life a social worker in the hospital is paged immediately so he or she can meet with the patient and intervene A mobile intake process that triggers specific interventions can improve outcomes and potentially even reduce costly hospitalizations and emergency department visits

LAUNCHING A MOBILE INTAKE PROCESSConverting to a mobile intake process requires a well-thought out plan Consider these strategies to ensure success

1 Obtain staff buy-in Front-office staff are the individuals who will educate patients about this new process which means their cooperation is imperative However organizations that leverage a mobile intake process will invariably reduce full-time employees serving in administrative roles and managers must prepare staff for this change

ldquoStaff can find the mobile intake process very threatening and they may even try to undermine it because of potential job loss This includes discouraging patients to participaterdquo says Henick ldquoThis isnrsquot something thatrsquos talked about but it needs to be addressedrdquo

Managers must focus on change management including the development of a clear plan for how positions will evolve he explains For example some organizations transition registrars into patient navigators who help patients use kiosks advise patients on Medicaid re-enrollment and more These individuals previously spent a significant portion of their time entering data into the EHR and shredding paper documents and can now focus on higher value add tasks

2 Know how the intake workflow will change With a mobile intake process patients provide an email address when booking an appointment Next they receive an email or text with a link to complete various intake forms Upon arrival to the provider the patient simply validates the information using an iPad and data automatically uploads into the EHR where a clinician can review it If patients donrsquot complete the intake forms prior to their appointmentmdashor


they only complete the forms partiallymdashthen they finish doing so using an iPad upon checking in

3 Make the intake process more valuable by aiding clinical decision-making MedStar Health has also incorporated a series of basic health questions into its mobile intake process As patients respond theyrsquore prompted to answer a series of additional screening-related questions For example if a patient indicates they have trouble sleeping theyrsquore prompted to answer several questions related to sleep apnea Clinicians review this information and are thus more prepared for a deeper dive into clinical discussions within seconds of meeting with the patient

4 Be prepared to provide options Even though most patients prefer a mobile intake process there will be a small subset who may ask for paper It should never be an all or nothing decisionmdashie only paper or only paperless Give patients the option at least initially and know that the adoption rate will continue to grow over time

5 Create a single set of demographic and clinical forms per department or specialty MedStar consolidated and shortened its forms prior to launching its mobile intake process so it could normalize and analyze data more easily and consistently

6 Think of a mobile intake process as a complement to your EHR Organizations that implement a mobile intake process successfully are those that integrate the intake process into their overall EHR deployment

strategy In some cases the EHR may already include built-in functionality thatrsquos necessary while in other cases organizations may need to partner with a third-party vendor that can integrate with the EHR

LOOKING AHEADIn the future a mobile intake process will incorporate even more artificial intelligence to help physicians become increasingly efficient

ldquoOrganizations can use a mobile intake process to make the patient visit less about information gathering and more about having an analytical discussion This could significantly improve healthcarerdquo says Henick

Itrsquos time to shift control of the check-in process to patients Theyrsquore accustomed to this model and eager for the efficiencies and access that accompany these tools A mobile user-friendly and fully-integrated intake solution supports strategic goals and provides operational and economics efficiencies that todayrsquos organizationrsquos need to ensure long-term viability l

Tonic Health provides a cost-effective mobile survey and payments platform that streamlines and improves

the patient intake process Tonicrsquos simple engaging platform seamlessly integrates with your EHR helping

you collect better data prior to the visit or at the point of service Tonic enables you to increase your

payments and decrease your administrative burdens all while offering an outstanding patient experience

ldquoOrganizations can use a mobile intake process to make the

patient visit less about information gathering and more about having

an analytical discussion This could significantly improve healthcarerdquo

-Adam Henick managing partner New World Health LLC


I n todayrsquos data- and efficiency-driven healthcare environment a paper intake process poses significant challenges for organizations and patients alike The fundamental challenge

for healthcare organizations is that it increases operational burden while decreasing data quality This is counterintuitive When organizations devote time and resources to managing the intake process they should expect accurate and actionable data Instead staff often spend several hours a day entering handwritten information into the electronic health record (EHR) This laborious task distracts them from patient-focused responsibilities and it also increases the likelihood of costly errors during manual data entry

Another challenge is that data remains buried in paper documentsmdashand unviewed by physiciansmdash

until someone enters it into the EHR This is information that could be extremely valuable to physicians and help them prepare to meet with each patient In addition there are costs associated with the paper itself This includes the cost to mail paper forms prior to appointments that patients ultimately donrsquot complete It also includes the cost to scan and shred paper that contains protected health information

For patients todayrsquos intake process is time-consuming and frustrating Organizations often ask patients to fill out the same forms repeatedly and paper-processes tend to increase wait times leading to patient dissatisfaction A staggering 76 percent of health systems report low patient satisfaction with their intake experience according to a proprietary Tonic patient intake survey conducted in May 2018



























3 Improves outcomes

4 Increases revenue


































































3 Improves outcomes

4 Increases revenue








































a better patient intake process · vwv i vÞ> ` «À ÛiÌ i*>Ì i Ì Ý«iÀ i vi 2 i n...

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