01. 02. 21
The era of patient self-service is here. The COVID-19 pandemic accelerated the pre-existing trend for patient self-service methods. Patients were already expecting health care to match the kinds of self-service options that exist in other industries such as travel and accounting, according to David Asch, M.D., Director of the Center for Health Care Innovation at University of Pennsylvania, Philadelphia.
Now more than ever patients have come to expect options for convenience, safety, and security in all of their transactions. With this, enabling patient self-service is good for the practice as well as the patient.
“Self-service has automated so many industries, allowing people to do things themselves. I don’t think there’s any reason we can’t do that in health care,” Asch said. “We’re used to an anytime/ anywhere culture, where people can check their bank balance any time or order products at 2 a.m. from Amazon. Adopting self-service methods is a requirement for health care transformation.”
By taking a comprehensive approach to self-service, practices will not only enhance the patient experience and build patient loyalty but improve their organization’s efficiency and bottom line. Perhaps the most immediate benefit to patients is the flexibility — and safety — of completing tasks and paperwork in advance of appointments, says Doral Jacobsen, CEO of Prosper Beyond, a company that assists physician practices with value-based contracting in Asheville, North Carolina.
“We know that sometimes patients don’t arrive as early to appointments as is optimum. From a practitioner standpoint, studies have shown that completing that paperwork ahead of time is more accurate. So, you get more robust information,” Jacobsen says.
Kenneth Hertz, FACMPE, principal at KTH Consulting, a health care consulting company in Dallas, Texas, thinks self-service is just “a better way of doing things.” He says the pandemic has pushed many practices to adopt these methods faster than they might have otherwise, which benefits both patients and providers.
“The online accessibility, the ability to transact business online and message your provider online is what people want,” Hertz says.
Hertz says this form of self-service also leads to an enhanced clinical experience. Staff can then maximize their time working on practice-building tasks such as tracking down payments, making sure referrals and prior authorizations are going through, or patient outreach.
Physicians and dentists should prioritize self-service, from scheduling to payment, as consumers’ demand for contactless payment methods is seeing a massive increase, according to Bloomberg, as high as 20% higher since the COVID-19 pandemic.
Furthermore, providers have long had issues managing patient services manually, which has a direct impact on a practice’s bottom line. According to the 2020 Medical Economics Physician report, providers who reported that their practice has seen declining revenue in the last year attributed the decline to two primary factors: difficultly collecting payment from patients and more time spent on uncompensated administrative tasks — two challenges that can be aided by patient self-service
What exactly is “patient self-service?” As Asch wrote, in a paper titled “Toward Facilitated SelfService in Health Care” for the New England Journal of Medicine: “Facilitated self-service means consumers can handle most of their needs without help.”
In an increasingly automated age, consumers in all industries gravitate toward what makes it easy for them to accomplish tasks and manage their lives quickly and conveniently, from online banking, to one-click shopping on Amazon and self-checkout at the grocery, to using Turbo Tax to file their own taxes. Patients are becoming accustomed to doing things for themselves in all aspects of their lives, and physicians and dentists will see the benefits of empowering them to do so.
For healthcare practices, the best places to start with patient self-service include online scheduling and payment, credit card-on-file technologies and text-to-pay capabilities.
These kinds of self-service are geared towards empowering the patient to take charge of their own situation, says Susanne Madden, founder and CEO of The Verden Group, a practice management consulting firm in Nyack, New York. To Madden, empowering patients means answering some basic questions: “Where do I find the services I need, and what does that starting point look like? Perhaps it’s telemedicine, perhaps it’s online scheduling.”
For example, Madden points out that patients’ ability to use their electronic health record’s patient portal improves their likelihood of accessing self-service options and benefits their care.
“Since patients can look up their care plans, their lab results, and send secure messages to their physician or dentist, patients are more involved in their care. There’s more info being pushed out to patients that they can read to better understand their care,” Madden says.
Accessing self-service options can increase a practice’s bottom line because it gives patients the ability to pay for the services on time. It also increases patient loyalty, because the practice is giving patients the kinds of service they demand in other aspects of their lives, says Karen Schechter, Director and Assistant Professor of Health care Management and Health Administration Programs at Maryville University in St. Louis, Missouri. “I think patients want to be empowered,” Schecter says.
And from a physician standpoint, she adds, it’s useful for patients to be empowered, because it allows physicians and dentists to focus more on managing care.
From a practice standpoint, self-service in the form of online scheduling and digital payments simplifies workflows, facilitates accelerated cash flow, and helps to reduce the need for additional staff. “If patients are doing these tasks, then the physician doesn’t have to,” says Asch. “The value proposition for the physician is in personnel reduction The savings of those costs can be distributed across clinicians and insurance companies.”
While there may be some necessary patient education involved in getting patients up to speed on using self-service, options, the benefits outweigh any challenges in doing so, Hertz says.
Another effective way to empower patients is to offer them as many payment methods as possible, and simple, digital ways to access them. Contactless payments can make the process quicker, more seamless and improve collection rates and build a healthier revenue cycle, Madden says.
“From the physician practice perspective, you absolutely want to make sure that you have an electronic way for your patients to pay,” Madden says.
Jacobson stresses that physician and dental practices should have a variety of ways to make it easy for patients to pay. “Have payment options on your website. Keep a credit card on file. Accept as many payment options as you can,” she says. “We’ve found that 80 percent of patients want to pay.”
She encourages making information available about medical credit cards for those patients who are struggling to pay. “Carrying forward with that medical credit card example, then the practice is paid, and now the economic relationship is between the patient and the vendor, not the practice. One less thing to worry about. One less statement to send. So, it saves the practice money.”
A simple place to start is just to keep a patient’s credit card on file. “We are big fans of keeping that card on file,” Madden says. “It’s not just for the physician’s benefit to keep cash flowing, but it makes it very efficient for the doctor’s office. It means getting away from the days of checks. For patients, it means no stopping by the checkout desk. No dealing with a paper bill coming in.”
Research shows patients are looking for a truly integrated consumer experience from their healthcare providers. A 2019 survey from Ernst & Young found that patients are eager to engage with their providers in seamless ways. For example, the survey found that 68% of patients want to be able to make an appointment online.
In addition, a recent AthenaHealth study analyzed more than 158 million claims across 33 million patients between 2017 and 2019, and found a positive correlation between patient portal and patient self-service use and growth in patient payment collections.
One important result of increased patient self-service is patient loyalty, says Schechter. “With any system, if you have a well-run machine, if things seem organized, and succinct and efficient, it builds patient loyalty and improves patient experience.”
She has seen more people leave due to inefficiency rather than a poor clinical experience.
“Patients love their doctors and clinicians but when it comes down to it, loyalty depends on how they are treated from a process standpoint,” Schechter points out. “When you go to a doctor’s office and you have a gazillion forms to fill out and you’re sitting there waiting, it wrecks a patient’s experience. Whereas, if someone comes in and has been able to fill out forms online and is seen in a timely manner because the tools of the practice make sure that happens, it keeps them loyal.”
Additionally, patients who have filled out paperwork or handled co-payments in advance may be in a better place to engage around issues of their care, says Jacobsen. Then physicians and dentists can focus their attention and energy on the reason for the patient’s appointment.
Text-to-pay options can make it simple for patients who are frequent users of their mobile phones — as almost everyone is these days. Americans spent about 3 hours and 30 minutes per day, on average, using their mobile phones, according to Vox.com, citing data from data measurement company Zenith.
All of these trends point in one direction for the value of patient self-service. “We need to be offering solutions that give patients greater flexibility, which is what they’re experiencing in other areas of their lives,” says Jacobsen. “We want things to be easy for patients.
“Patient self-service leads to a greater degree of accuracy of information. And then it also allows staff to be freed up. Instead of doing things that the patient’s capable of doing, they’re focusing on other tasks in the practice that the patient couldn’t possibly perform. So, it’s more efficient.”
This efficiency is a result of taking tasks out of the hands of front desk staff that the patient can handle, Jacobsen says. “When front desk staff are trying to input the address, and the subscriber ID and all of these things, and they’re interrupted by a phone call or someone in front of them, many times those data entry errors create denials. Claim denials, claims get kicked out. There’s no clean claim.”
This has a negative impact on the revenue cycle. “One of the problems that we see in practices all the time is that the demographic data entry errors create a lot of backend work,” Jacobsen says.
Aside from efficiency, patient self-service enables providers to spend more time with the patient ultimately working on preventative care, says Hertz. That translates to less time dealing with critical or acute issues and better outcomes in patient care.
The more automated and contactless processes a practice has in place, says Schechter, “It’s going to put your staff in positions where they’re doing meaningful work and getting things done that hopefully lead toward quality patient care, and also generating revenue and increasing the bottom line.
When it comes to implementing patient self-service, practices can leverage healthcare technology to provide the services patients want, and ultimately get paid faster.
To do this, practices need to be online in some form, Madden insists. “People live online,” she says. “That’s what we’re all doing so you have to meet your patients where they’re at.”
For many practices, this may simply mean adding on technology to their existing EHRs, but others may be dipping a toe into a new area altogether.
Physicians and dentists can seek the advice of other practices that are already up to speed. “I always tell the providers I work with that they need to get people who are experts in their field,” Schechter says. “Next, ask, are you using your EHR to its fullest? Are there functions or add-ons that are available that are seamless? There are so many wonderful technology opportunities and alternatives that integrate with EHRs.”
At the very least, physicians should start with a website that allows access to forms and payments, Jacobsen encourages. “Connect with the vendors to help you set up those things if not in place,” Jacobsen says. “Collect email info from patients, and also consider patients who like things to be text-based or mobile. Most patients will have a smartphone, so if you make it easy and walk them through simple apps they can download, it will help you get the information you need as a practice.”
It’s normal to fear change and be overwhelmed by technology, Asch says, but in the long run it will only hold a practice back. “No one wants to believe they have a job a machine can do. But machines can’t do physicians’ job. A machine can manage hypertension, but it can’t manage a patient.”
“When you move to being able to offer the freedom and flexibility for your patients to schedule an appointment any time they need to, or pay online, that’s a radical shift from how things were done before,” Madden says.
Ultimately, patient self-service starts with mindset. Practices must be willing to embrace change and understand the value of putting the patient more in control of the overall experience. Then, the focus turns to approach. Providers, office administrators and IT professionals must adopt the right technology, implement new systems seamlessly, and utilize the feature sets to maximize return on investment. When practices make it easier for patients to access care, then they receive the benefits of improved satisfaction, increased loyalty, more appointments, and faster payments. Patient self-service functions as a vital component of patient-centric healthcare, allowing your practice to grow and thrive.
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