I think you're referring to this: https://www.wired.com/2015/03/how-technology-led-a-hospital-to-give-a-patient-38-times-his-dosage/ It's a fascinating example of the swiss cheese effect, and should be required…
HIStalk Interviews Brian Schmitz, CEO, Clinect Healthcare
Brian Schmitz is founder and CEO of Clinect Healthcare of Charlotte, NC.
Tell me about yourself and the company.
I have 20 years in healthcare IT and the company is 10 years young. With Clinect Healthcare, practices and health systems can collect, monitor, measure, and act on their patients’ experience throughout the cycle of care, pre-, during, and post-encounter. We provide an integrated mobile-first and fully automated approach for intake, patient-reported outcomes or PROs, and patient experience, as well as provide the tools to gain insight and to act on patient responses in real time.
What kinds of technology solutions have become important during the pandemic?
People ask me, how has COVID impacted your business? I say that it doesn’t matter. How has it impacted our customers’ business and what technology are they asking for that allows us to help them?
As a case in point, one of our intake and PROs customers is expecting to have north of 20,000 new patients during Phase 1B alone. The same customer will see 832 patients today because of the Pfizer vaccine compared to 184 new patients one year ago today. There is a wave of new patients getting ready to descend on practices. We’re talking about the largest scale vaccination attempt in modern history. A positive patient experience for that new patient could translate into a long-term customer, so I recommend measuring their patient satisfaction and giving them a chance to feel important throughout their vaccine journey. Patient acquisition is in play.
But anecdotally, we’re seeing more and more technology interest to measure the efficacy, measure the side effects within the practice, but oversight of those patients is key. Using a PROs type platform where providing the automation, integration, and outreach to follow the journey pre- and post-injection. A learning based on response thresholds is also important. But the best part is that we have patients’ clinical artifacts — age, chronic conditions, medications, allergies, et cetera — from the EHR. Marrying up those with PROs feedback for analysis is priceless.
Suffice it to say, healthcare systems and practices will need to prepare for high patient volume with COVID and the COVID vaccine. Intake solutions will be convenient with the influx — I get it, we offer it, too — but PROs are critical to drive value-based change and increase revenue. That is true beyond COVID. It is diagnosis- and specialty-agnostic, but that’s the type of technology that we’re beginning to see from a remote patient monitoring perspective within COVID.
How are providers, especially the smaller and less sophisticated practices, managing COVID-required activities such as selecting patients for the vaccine, notifying them, reporting the injection, and following up for their second dose?
There’s a behavior change and heavy lift that’s going on, both within the electronic health record vendors and working with the providers to ensure that we are able to collect new information within the medical record chart and PM system, as well as report those that fit the criteria for that next phase. Working within those confines, and working with the reportability of those systems, is key for the reach-out of bringing those patients back into the practice.
How will the tracking of vaccine side effects work in terms of patient-reported outcomes?
The PROs, the patient-reported outcomes side of it, is driving the need to measure what’s going on. We are finding that there are a lot of unknowns out there as it relates to the efficacy rate of these particular vaccines. Being able to leverage technology to have touch points post-vaccination throughout the first shot — how are you doing, how are you feeling — past the second shot. Identifying side effect information is very important. Healthcare systems and provider practices are just now understanding that this is an important thing to measure, and they’re looking at technology in order to automate that process and to bring information back to them in real time so that they can act on anything or any threshold that is out of bounds.
What is the state of the industry in using patient-reported outcomes to drive follow-up workflow on the back end instead of waiting for them to call with questions or to make another appointment?
Taking a proactive approach and engaging the patient is the key to getting more real-time understanding of what’s happening with the patient. As an industry, we’ve done a decent job of creating point solutions for interacting with your healthcare providers on an administrative level – portals and online scheduling, web payments, and so on. That’s a reactive approach. It’s time for the patient to have the opportunity to have a discussion with their care providers that is a proactive approach into their world. We’ve shaped our platform to do just that. They will engage at the conversation feedback level, where questions can be asked and responses can be acted on, in and out of the examination and the procedure room.
Is the coexistence between EHR vendors and third party solution providers better defined than in years past?
It is. We have great partnerships, from a data integration perspective, with the top PM and EHR companies that are out there, and the working relationship has been great. In fact, with COVID, we’ve formed a strong collaborative with a top EHR vendor and the health system that we worked with to ensure that the integration is in place and the data collection that we are taking is being consumed by the electronic health records in a meaningful way. I think they know where their space is, and they recognize that our solution complements the ability to reach patients both in and out of the office.
COVID has shown how archaic the process is of stacking up patients in waiting rooms or in the checkout line. How well have we used technology to streamline that?
We have advanced it so much over the years because the nature of what we want to learn and collect is changing. Even when looking at COVID, for example, the waiting room has extended into the parking lot and into the cars of the patients. So the timing in which we collect information has shifted. The nature of what needs to be collected has changed.
This has allowed patients to become more comfortable using their devices. We subscribe to mobile-first, and I personally subscribe to the idea that the lowest common denominator of technology is a button click. Being able to provide an easy approach to documenting your health history and your insurance information, your demographics, as well as PRO information that is meaningful, scored and pushed back to the medical record chart has been adopted very well by patients. We’ve seen that over the years and certainly with COVID, it is becoming more and more accepted by patients to fill things out outside of the brick and mortar of a practice.
Is there a software opportunity in the higher abandonment rate of patients who get tired of waiting for their telehealth visit to begin?
There is. When we talk about telehealth, we’re talking about a remote encounter. We need to focus on is making the patient feel as though there’s an extension of that remote encounter. We want to capture information ahead of the visit that will be meaningful for the provider to have. W want to monitor that patient to follow up with the their diagnosis. A solution that can complement a specific telehealth visit allows us to provide more of a holistic approach for the patient, both pre- and post-telehealth visit, for better care overall.
Who will be the driver of tools and processes for that interaction – primary care doctors, hospitals, or insurance companies?
It falls at the provider level. We are seeing a lot of interaction right now with payers that are interested in gaining insight and learning best practices, best techniques that could then be relayed down to their provider base. But there’s a lot of specificity to what PROs provide. With value-based care, it’s going to be very important at the specialty, practice, and health system level to measure their patients to identify the best techniques and best practices that work for us, that we can then also educate the patient on so that they can be more engaged into their care. A healthy patient is a more profitable patient. It gives us an opportunity to measure that at the local level so that they can act, because that is their patient and the relationship is within that patient.
Do you have any final thoughts?
Given the state of technology, as well as the sudden shift where remote and electronic interaction is acceptable and required in some cases, the cycle of care can be even more continuous and less episodic. Sitting in an exam room isn’t the only place where critical feedback can be received any more, but it needs to be simple for patients and easy to access for staff. The use cases with a platform like this are endless.
Great article and a timely solution to some of the shifts we are seeing in the provider space.