How Texas Health Resources traded phone trees for online registration and gained a 97% show-up rate
CLEVELAND – At the Cleveland Clinic and HIMSS Patient Experience Forum on Wednesday, Sabina Mujanovic, patient advocate at Texas Health Resources, described her own trip through the tangled phone tree that patients were expected to navigate when hoping to schedule an appointment.
You've heard variations of the same recordings yourself: "your call is important to us" … "if this is a medical emergency please hang up and call 911" .... "for English, press one; para Español oprima dos" … "if this is a physician calling to speak with another physician, please press 3."
After wading through those options for perhaps a minute or more, Mujanovic had a thought.
"No wonder they hate this," she said.
The option for patients to book an appointment was #5 on the phone tree list. That's not optimal for an organization that prides itself on putting patients first.
Whether it's long-winded phone prompts or clipboards stacked with forms asking for the same information over and over, "apparently we are very selfish," Mujanovic said of healthcare providers in general.
"We keep doing what works for us," she explained. "We say we care about the patient – and we do – but we put up barriers. And we create suffering, unintentionally."
Indeed, there had been deep frustrations at Texas Health Resources' outpatient behavioral health clinic, with patients complaining in detail about the the inefficiencies and repetition of the registration process.
So the health system conducted more than a dozen focus groups with patients already in treatment to get a sense of their pain points and find out how the experience could be improved.
Before, the complaint forms had been full of emotional responses to the indignities of a rather bureaucratic process:
- I waited for hours without an update
- I was not in the right state of mind when I was discharged from inpatient to PHP. Despite my confusion and anxiety I was told to do more paperwork which seemed overwhelming and also not necessary given that you already had all the information you asked me to provide for you the second time,
- Please offer a possibility for registration and forms to be filled out electronically.
And so THR did just that. By leveraging Epic's MyChart for appointment scheduling – notably doing a custom build to incorporate intake screening questionnaires into the portal, allowing them to be filled out ahead of time at the patients' convenience – the health system was able to improve the process to such a degree that Mujanovic could justifiably title her talk: "Patients Fall in Love with Online Registration."
That may sound like hyperbole. But the numbers, despite a widespread belief that patients are generally uninterested in using their online portals, bear it out.
By using MyChart – and, not insignificantly, reducing the number of forms from 40 to three, removing redundant questions, standardizing and streamlining the process – Texas Health Resources saw a major increase in its show up rate: from 30 percent in the paper-and-pencil days, to 97 percent with the portal.
Time spent in the waiting room also decreased, from 35 minutes to five-to-seven minutes, on average.
And patients were grateful for the improved experience. There was a big boost in their "speed of registration" ratings on Press Ganey surveys, from 59th to 95th percentile.
Best of all, a better check-in experience enabled better care.
"Patients came in ready," with the right information and the right state of mind, said Mujanovic. "That helped us as providers, and gave us some flow and some stability."
Digital Transformation in Healthcare
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