In recent years, clients have come to expect more technologically advanced ways of interacting with all healthcare providers, including rehab professionals. With this in mind, Rehab Management put together this roundtable of software manufacturers to discuss how rehab facilities can increase patient engagement by making the most of technology such as patient portals and digital communication.
Participants include James Heathers, PhD, chief scientific officer, Cipher Skin; Sharif Zeid, business director, MWTherapy; Rayna Lea, demand generation manager, Net Health; Holly Haberkorn, program coordinator, marketing, Netsmart Technologies Inc; Steven Presement, president, Practice Perfect EMR; and Brian Kunich, PT, OCS, COMT, director, product management, WebPT.
How have your rehab facility customers changed the way they use technology for patient engagement in recent years, including during the COVID-19 pandemic?
James Heathers (Cipher Skin):
COVID forced an immediate and gigantic change in technology usage. It was both a regulatory unlocking event—changing the insurance status of telehealth—and a forced change in practice, as providers had to figure out telehealth from scratch.
What’s interesting now is: there’s something of a regression. Many people prefer provider contact, and provider treatment and payment systems presuppose it. By late 2021, much of the telehealth volume had slid back. But the door is permanently open now, so the ‘new normal’ is much more digitally friendly than 2019 and we are seeing many providers adopt hybrid approaches to care.
Sharif Zeid (MWTherapy):
We’ve definitely seen a big uptick in patient engagement over the past few years. From our perspective, COVID really enhanced trends that were already either happening or starting to happen. The biggest change we’ve noted is in expectations. Today’s rehab patient expects a modern experience: self-service registration, online booking, online bill-pay, and other convenient interactions with the practice they are utilizing for care. At the same time, practices are seeing tremendous time-savings and efficiencies in letting their patients self-serve. This is especially beneficial when many practices are struggling to hire and retain employees. In some ways, it’s the perfect storm for rapid enhancement in patient engagement.
Rayna Lea (Net Health):
Rehab Facilities are now automating patient review capture, promotion and online reputation management with the Patient Engagement Suite. Prior to leveraging patient engagement tools very few facility reviews were posted online, inaccurate company information was plaguing searches, and the quality of service was not properly reflected.
Holly Haberkorn (Netsmart Technologies):
In recent years, technology has drastically changed the way rehab facilities engage with patients. This is especially apparent during the COVID-19 pandemic, when many facilities have had to rely heavily on technology to provide care. Facilities were forced to implement a variety of technologies to help decrease in-person contact, remain in touch with patients during their rehab journey and to make up for the diminishing number of employees in the workforce that the pandemic has caused in so many industries.
For example, to eliminate patients congregating in waiting rooms many clinics implemented a mobile check-in process allowing them to use their cell phones to notify clinics when they arrived. Previously, it was much more common for patients to walk in and interact with front office staff members and other patients while waiting for their appointment to start. Another example would be the introduction of telehealth in the rehab world. Most would attest to the fact that rehab services are much more beneficial when conducted in an in-person setting; however, if providers wanted to stay in touch with their patients and continue to get paid, in some capacity, telehealth was the only option.
Steven Presement (Practice Perfect EMR):
Covid has forced clinics to escalate their plan for remote patient engagement. There has been a big shift to being able to handle communications remotely relying much more heavily on online forms, telehealth, and text communication. The goal is to minimize the front-desk interaction time and have the patient doing as much remotely, as possible. While treatment has returned primarily to in-clinic, we are finding that all the remote automation has been introduced over the past few years is staying put. Patients love self-service.
Brian Kunich (WebPT):
The pandemic fueled interest—from both providers and patients—in using new technology during treatment. Notably, our 2022 industry report unearthed that 22.5% of clinic leaders stated that they’ve invested in digital home exercise program (HEP) software. Digital HEPs enable therapists to expand treatment beyond the clinic, helping patients stay on track with their treatment goals. HEP software also goes hand-in-hand with another rising industry trend: remote therapeutic monitoring (RTM). RTM allows therapists to monitor patients progress and outcomes through software that tracks patients’ self-reported data. Both of these innovations can help increase patient engagement to drive greater outcomes.
What is the most important way your product helps rehab facilities increase patient engagement?
Cipher Skin’s Biosleeve, in tandem with its Recovery App, helps increase patient engagement through data, contact, and context—and you can’t miss any one of them. Data: set a measurement environment on the body, record progress, graph progress. Contact: give providers instant ways to reach out to patients—one-button email and SMS, and telepresence. Context: let providers navigate, reflect, reinforce progress. In a phrase, confront people with their success.
MWTherapy has been pioneering patient engagement for many years. We facilitate text and email reminders to patients helping practices significantly reduce cancels and no-shows. We enable things like virtual check-in and online schedule via our built-in patient portal. We also help facilitate communication between patients and practices. Our system also automated marketing to help practices attract and retain patients with higher quality outcomes. Another example of patient engagement would be our Home Exercise Program, which can really help with outcomes and is part of the patient experience formula as well.
The Patient Engagement Suite integrates directly and seamlessly into the company’s existing EHR. The software allows staff to quickly identify positive patient experiences and send them a request for a review and rating. The Patient Engagement Suite delivers the flexibility to reach the right patients at the right time in the right way to help build a strong online presence.
During the COVID-19 pandemic, when clinics needed a way to stay connected with their patients, our development team was hard at work developing a variety of options. Within two years, we developed and released patient surveys, mobile check-in, telehealth, the schedule optimizer (aka an automated waitlist), and online scheduling. That’s five products that work seamlessly with TheraOffice. Clinics can choose to implement one feature, all five features, or any combination that works for them and their needs. Not only do all of these features allow clinics to communicate and improve patient care, but they were also built in-house. This means that they fit right into the TheraOffice workflow that users know and love. There are no additional databases to manage or passwords to remember.
Practice Perfect EMR:
Automated texting campaigns and two-way texting has dramatically increased client compliance. By being automatically in touch with the client on a regular basis, via text messages (which have a very high read rate), the clinic remains top-of-mind with messaging ranging from appointment reminders to “How do you feel after today’s session?” to “Hey, we haven’t seen you for a few weeks,” to “Sorry, your therapist is out sick today, please don’t attend,” and finally to automated surveys. Text automation literally drives non-compliant patients back to the clinic and, since it’s fully automated, might even save you some precious human resource dollars.
Proactive outreach. Consistent patient-provider communication before, during, and after therapy increases engagement and retention. A patient relationship management (PRM) software, like WebPT Reach, can help PTs stay consistent in these efforts as their practice grows, collect patient feedback, and send out targeted communications. Likewise, digital patient intake solutions help streamline the intake process by providing patients with their paperwork in a digital format so that they can complete it before their appointment—and spend less time in the waiting room, enhancing their experience overall.
How important is the use of a patient portal in patient engagement?
Quite important. Home exercise is much more frequent than in-clinic visits, and data always goes in or out through that portal. So, it needs to be good enough to support continual access. A bad or confusing interface, especially for non-digital native users, is fatal to repeated use. The median PT patient for some conditions is Medicare age. Cater to them.
The importance of a patient portal can’t be understated. Whereas some years ago a patient portal may have been considered a luxury, its core functionality by our standard in today’s world. Practices that aren’t employing a patient portal are missing out on an opportunity to drive more revenue and better outcomes. MWTherapy’s patient portal, for example, offers many self-service options and easy ways to integrate into your website or share with patients directly. The key is getting something in place and then encouraging patients directly and indirectly to use it. Practices shouldn’t feel that patient portals are all-or-nothing. The important thing is to start implementing and then build from there.
It is important to connect with your patients outside of visits to strengthen your relationships and ensure completion of care. Keep patients on track and motivated throughout treatment by providing insight, encouragement, and tips for at-home care between visits.
The use of patient portals was on the rise even before the start of the pandemic in 2020. We knew that it wasn’t going to be long before that trend hit the rehabilitation world and sure enough, it did. Patient portals allow patients to register online and fill out all of the tedious paperwork that needs to be completed prior to their first visit. They can do this from the comfort of their own home while using their own personal device.
We all love when providers can spend more face-to-face time with us, as their patients, and our portal allows them to do just that. A more recent version of the portal has allowed providers to send functional tests as well. Again, this eliminates the time that patients have to spend filling out the questionnaire in the clinic and allows for more treatment time.
We know for a fact that more and more practices need to be able to communicate with patients after the initial registration process; therefore, we are considering a variety of ways to enhance our portal to allow for that. I believe the more that providers can communicate with patients, the higher chances of them completing their plan of care successfully.
Practice Perfect EMR:
A patient portal is typically much more valuable at the start of treatment, where forms need to be sent back and forth and initial appointments need to be booked. After-hours, self-service access is key, allowing for patients to review everything on their own time. However, once treatment begins, the portal’s importance tends to fall off. Yes, appointment reminders are key, but document exchange doesn’t happen as often once treatment has begun.
That being said, a client portal can be a great tool for helping with client copay and deductible collections, with statements being available online along with credit card payment processing. For a clinic with a large private-client base, a good portal can make all the difference for your cash flow.
When used effectively, utilizing a patient portal can greatly improve engagement and outcomes. For example, our HEP patient portal allows therapists to set (and update) patient goals, track their workouts, answer patient questions in real time, and communicate with them about their treatment. The ability to have meaningful interactions with your patients outside of the clinic is particularly important to their satisfaction. Per our PT Patient Experience Report, “when therapists check in on a patient’s progress between visits, the success rate of HEP is 94%, compared with only 67% of patients not receiving regular communication.”
How can rehab facilities decrease “no shows” for appointments?
There are already mature solutions for this, and they work: automated reminders, scheduling, call management, app alerts, etc. Our platform has them, as do many others. SMS reminders are one of the most successful medical interventions ever researched.
Reminders are a great way to cut down on no-shows (and cancels). No-shows are challenging because that slot and its associated revenue is almost always lost. Keeping patients aware of their visit ahead of time is a relatively easy way to combat this, especially when using a system like ours that can automate these reminders. There’s certainly more that can be done than just reminders. Newer technology includes a confirmation workflow where the patient can confirm they will attend as well as having a robust wait-list functionality.
Appointment reminders are a great way to decrease “no shows” for appointments.
There are a couple ways that clinics can decrease the number of “no show” appointments. First, I would implement an appointment reminder system. Whether this is a staff member that is responsible for confirming appointments or is an automated service, it is key to increasing the chances of patients showing up. At the very least, if a patient breaks their appointment during the confirmation window this should give clinic staff members enough time to try to fill the open appointment slot.
Additionally, I always try to minimize the time that patients spend in the waiting room. This instills confidence in the patient that they will be in and out of their session during the designated times and not miss other events scheduled during their day.
Generally speaking, I strongly believe that patients do not, intentionally, want to miss their appointments. In most situations, patients want to attend their appointments because afterwards they feel better. Afterwards, they feel as if they are on a path to recovery. With that said, emergencies always come up, making “no shows” inevitable.
Practice Perfect EMR:
There are two key elements in reducing no shows—first, appointment reminders via text, a phone call, or email reminding the patient of their obligations. Second, instituting a late cancel/no show penalty will also help, where possible. Money talks and if a patient believes they will need to pay for a missed appointment, they will either cancel or make best efforts to show up. Dentists have been doing this and getting away with it for years. Why not rehab therapy professionals?
Frequent communication. Automating text or email appointment reminders by using a patient engagement tool that integrates with your EMR—like WebPT Reach—is a proven way to improve patient retention and decrease no-shows. Similarly, streamlining the check-in process through digital forms can help improve the registration process while also serving as another appointment reminder.
What are the best forms of communication to boost patient engagement?
There are literally hundreds of research papers on digital intervention and reminders. The bottom line is all of them work for someone, so have them all and let them choose.
Text, email, and phone all have their place in any practice. The key to using them is finding the right balance and timing for each—and personalizing that per patient as much as possible. Successful practices find a good formula for keeping in touch with patients through various mediums that isn’t too much and isn’t too little. The other piece of the puzzle is timing. Successful practices not only communicate with the right patient and the right message, but also at the right time.
Maximize existing staff and resources with automated patient-provider messaging integrated directly into the EHR. Streamline the patient intake process by sending electronic intake forms to your patients that automatically upload to the EHR, reducing the amount of time your patients have to spend in the clinic. Allow your patients to request appointments at their convenience without calling the clinic. Enable your clinic staff to respond to requests as soon as possible. Do not keep your patients waiting for a response; they may find another provider in the meantime.
): We all, for the most part, have access to a smartphone that puts an endless amount of data and connectivity at our fingertips. Because of this, the more information and communication that can be handled via texting, emails, and phone calls, the better. And the more ways that you can encourage digital engagement, the better. For example, run a poll on your social media or provide a free giveaway to someone that shares your post or refers a friend. Send out email reminders introducing new staff members or congratulating patients (with their consent, of course!) on their rehab journey. Striking the right balance of technology, frequency, and depth of engagement will be key, as digital communication evolves.
Practice Perfect EMR:
In the world of spam, virus checkers, ransomware, etc, it is definitely harder getting “in front” of the patient. Texting is the way to go – everyone reads their texts messages, usually right away, and they can be retained and reviewed with a few clicks, unlike a voice mail. For now, texting almost guarantees you an audience. And texts are super-easy to reply to, without having to “deal” with anyone live.
Communication is the most critical factor to patient-perceived success. However, only 30% of patients report regular communications from their provider between appointments, according to our recent survey. Simply ask patients how they prefer to receive communications during their initial visit, and then reach out to them to share appointment reminders, motivating messages, and updates via that channel. This includes your older patients, too. Oftentimes, they receive fewer communications between appointments; however, they typically need the most motivation to stay on track with their therapy goals. You may even be surprised to find out how many now prefer digital communications.
This is an expanded version of a feature that originally appeared in the Sep/Oct 2022 issue of Rehab Management.