Improving patient outcomes & continuity of care through communication technology

Healthcare innovation saves lives—plain and simple. Consider how much healthcare in the United States has changed in the last 270 years. It’s evolved from home remedies and town doctors to an incredibly complex network based on medical science and advanced technology.

Twenty-first-century technologies continue to improve patient outcomes with advances like: 

• Preventative treatments for genetic diseases 
• AI that assists in drug discovery and development
• Surgery innovations
• The emergence of telemedicine/telehealth services

COVID-19 has accelerated dramatic changes in healthcare in a matter of months. There is an enormous opportunity before us, one that can meaningfully improve patient outcomes and decrease the cost of care: communication technology. 

Harnessing communication to improve health interventions & patient outcomes 

Missed patient appointments cost the US $150B each year. Doctors’ offices, dentists, and hospitals routinely send text appointment reminders to decrease this major drain on resources. Since a growing majority of Americans prefer to get notifications via text, the result is fewer patient no-shows. Appointment reminders only scratch the surface of texting potential in healthcare. There is a larger opportunity to improve continuity of care and patient outcomes. 

A review of studies on SMS use in healthcare found that texting was an easy and inexpensive way to increase patient treatment adherence. We know appointment reminders decrease no-shows. Text message health interventions take the tool a step further and serve as after-hours health checks. Lifestyle coaching via texting has been shown to improve health outcomes for patients with chronic conditions, increase vaccination rates, and improve medication adherence. 

Non-adherence to medication accounts for a massive number of treatment failures and approximately 125,000 deaths per year. Compliance rates of 80 percent are necessary for optimal patient care, yet medication adherence for chronic conditions hovers around 50 percent, with these patients costing the healthcare system more money. In a study of 2,742 patients, the use of text messaging for medication reminders improved adherence rates by 17.8 percent. It’s safe to assume that wider use of text message health interventions could help save costs in the long run. 

The use of text messaging in healthcare and the transmission of personal health information (PHI) still has some legal limitations. However, the benefits of using mobile devices beyond appointment reminders for medication adherence, healthy living tips, and continuation of care have been shown to contribute to overall health outcomes. To further leverage the potential of mobile devices in healthcare, verification protocols like 2FA (two-factor authentication) can increase the security of physician/patient interactions. 

Flexibility in technology use helps improve care & decreases costs

Physician burnout is an epidemic. With more than half of US clinicians experiencing symptoms of burnout, it’s important to place focus on the providers who deliver care. Clinicians’ health and well-being have direct impacts on the patients they treat. The quadruple aim of healthcare seeks to improve the clinical experience to positively impact health outcomes and patient experiences, and ultimately decrease healthcare costs. 

Doctors and nurses spend as much as 6 hours per day on data entry. It’s enough to give anyone a headache, but these administrative tasks take them away from the real business of treating patients. Automated text or voice reminders to patients with health interventions and confirmation of appointments are easy ways to improve the workflow. Texting is being used to further decrease administrative tasks and costs in a growing number of ways: 

• Streamline check-in/check-out procedures
• Collect health history, ID, and insurance information
• Bill payment
• Sending instructions pre & post procedures
• Patient surveys via text for higher response rates

When clinicians have the opportunity to communicate with patients over multiple communication platforms like voice, text, and in-app calling technology, it improves work flexibility and increases patient access to care. This is particularly important for rural areas which often have less access to in-person visits and patients with chronic conditions that drive hours to see specialists. Health systems have consistently utilized nurse helplines to prevent unnecessary admissions. Most hospitals and providers across the country have some form of 24-hour nurse lines to manage patient flow. This makes sense since a 2018 study found that nurse triage lines prevented 2 out of 3 ER visits. When the average visit to an emergency room costs $2,000, phone triage services prevent many unnecessary hospital admissions and avoidable healthcare costs. 

Texting and telemedicine increase healthcare access

Providing communication flexibility doesn’t just help providers, it also increases healthcare access for patients. Mental health professionals have taken recent steps to leverage texting to be available to patients outside normal office hours. Senior citizens, people without reliable transportation, and patients with disabilities are just some of the populations where access to healthcare can be disrupted. Texting, voice calling, and telemedicine are all tools that increase their healthcare access. 

Telemedicine has gained in popularity with physicians recently over the years because of its ability to solve common issues like reducing readmissions. In 2019, 800 physicians were asked why they embraced telemedicine:  

• 93% felt telehealth visits improved patients’ access to medical care
• 77% stated the service made better use of time between doctors and their patients 
• Telehealth visits among physicians is steadily increasing (69% in 2019 compared to 57% in 2015)
• Physicians cited an increase for healthcare access and ability to attract new patients among the reasons they adopt telemedicine services
• Televisits for routine care will continue as CMS and other insurance companies expand reimbursement for the service as well as remote patient monitoring platforms. 

Increase in telemedicine adoption

Telehealth use accelerated to warp speed due to COVID-19. As most hospitals across the country postponed all non-essential procedures, healthcare practices moved online almost overnight. Not surprisingly, The Journal of the American Informatics Association showed televisits grew by 685% for urgent care visits and by 4,345% for non-urgent care in the first months of stay-at-home orders. The rapid adoption of telemedicine helped maintain social distancing guidelines set by the Center for Disease Control and preserved dwindling PPE. Physicians discovered an unexpected benefit of seeing into patients’ home environments and gaining a clearer picture of their overall health.

Not every patient is tech-savvy and the online platforms have adapted. By texting links directly to mobile devices, platforms make it easier for patients to connect. It’s likely that the convenience and many benefits of telehealth will mean more patients use it for routine care. Making the platforms more user-friendly with voice and messaging APIs can keep visits moving along if there are video lags. 

Out-of-hospital patient monitoring increasing

Alongside telehealth and triage lines, out-of-hospital patient monitoring is on the rise (thank you, Apple & FitBit!). In 2017, around  64% of patients used some form of a digital device like apps or wearables to manage their health. Over 70% of patients wanted information in those devices to be given to their doctor. In fact, in 2019, the Centers for Medicare & Medicaid Services updated plans for providers to charge for mHealth and telehealth technology. This included billing codes for the review of medical devices like blood pressure monitors, pulse oximetry devices, and respiratory flow rates. The new guidelines allow for “clinical staff” such as nurses and medical assistants to perform the monitoring and will decrease physician workloads. Increased acceptance for billing of telemedicine and connected medical devices will have a huge impact on further adoption. 

The future of technology in healthcare

The future of healthcare innovation is starting to look like an episode of Star Trek. It will include AI, advancements in remote patient monitoring, IoMT (Internet of Medical Things), and better cloud integration for existing technologies. If you really want your mind blown, look up “digital twin healthcare”. Large tech companies like Microsoft, Apple, and Amazon are investing mass resources in the healthcare industry. Their involvement will likely cause additional acceleration of the industry’s digital transformation. We are rounding the first corner in the race toward using omnichannel communications to enhance personalized medical care. There is still a long way to go. New advancements will move the healthcare industry along its quadruple aim goals: creating more efficient clinical experiences, better patient experiences, improving population healthcare outcomes, and ultimately decreasing the costs of care. 

Looking ahead

Healthcare is just scratching the tip of the iceberg when it comes to omnichannel communication technology. Regulations like HIPAA compliance and physician fee schedules are often seen as barriers to the free flow of information between physicians and patients.

Technology will likely always outpace governing bodies. Regulators, payers, and healthcare administrators need to find a quicker path forward to leveraging communications in healthcare. Becoming more flexible and welcoming to innovation will only help the healthcare system adapt to new challenges and improve outcomes. A healthier society will decrease medical costs, ultimately benefiting everyone’s bottom line.