In today's dynamic healthcare landscape, providers play a pivotal role in nurturing strong relationships with their patients. With the right technological solutions and streamlined workflows, providers can identify unengaged patients and establish foundational relationships. By embracing a proactive approach that encompasses patient outreach and scheduling, pre-visit reviews, and concurrent coding, providers can optimize their care delivery and build meaningful connections with their patients.
Solution #1: Patient Outreach & Scheduling
In 2021, 82.3% of adults and 91.0% of children saw their doctor or health care professional at least one time. However, all patients should be seeing their provider at least once a year to detect emerging health conditions and allow for early interventions, treat existing conditions, and support preventative care. Patient outreach and scheduling is a proactive approach that assists patients in scheduling a visit with their provider and connects them to a provider if they are not already aligned to one.
By reaching out to patients without scheduled visits, we gain valuable insights into their needs that may be preventing them from seeing their provider, such as transportation challenges or distance from a provider’s office. Establishing relationships through patient outreach can help address barriers to care through additional solutions such as transportation services, telehealth, or in-home assessments.
In general, patient outreach should be implemented on a broad scale by contacting all patients without a scheduled visit in the year. However, smaller provider offices with limited time and resources can utilize a phased approach by starting with a targeted focus on specific segments of patients who may experience greater benefits from seeing their providers. When taking a more focused approach, here are three segments that are important to focus on:
- Patients new to a plan or program that lack foundational relationships with their providers
- Patients who have been unengaged for over a year
- Patients with historical chronic conditions who have not seen their provider for over a year.
Consistent provider visits are important to all three of these types of higher-risk patients to support preventative care and optimize care management.
Solution #2: Pre-Visit Reviews
Studies have shown that the average physician spends more time on administrative tasks than on actual face-to-face time with their patients. To help alleviate this burden, providers can leverage pre-visit reviews, a type of prospective coding solution, to maximize the valuable time needed to take care of patients.
For example, Episource’s Pre-Visit Review service utilizes analytics technology to distill historical patient data to accurately identify patients who may need health interventions before a visit with their provider. With this key information like year-over-year and clinically-indicated diagnoses readily available, providers can focus on meaningful interactions, actively engage with their patients, and have more time for comprehensive assessments, discussions, and shared decision-making.
In addition to helping increase the accuracy of clinical documentation, pre-visit reviews can also help refine coding processes for provider groups new to risk-based arrangements. Our cloud-based coding platform, Episource Coder, supports pre-visit reviews by providing the ability to address ambiguous documentation, enabling providers to improve their clinical documentation integrity (CDI) team and create a continuous feedback loop.
Solution #3: Concurrent Coding
After a patient visit is complete but before a claim is submitted, concurrent coding can be used to clarify any documentation at that time. This solution provides real-time feedback on the coding’s accuracy and completeness, enabling the provider to immediately address any uncertainties or ambiguities in the documentation.
Concurrent reviews can effectively decrease time spent on administrative work and increase the available time to treat new and emerging conditions for patients and provide ongoing treatment. The combination of pre-visit reviews and concurrent coding can enhance quality of care for patients, reduce administrative burden for providers, and improve documentation accuracy.
Adopting the Patient-Centered Paradigm
By embracing customized, technology-driven solutions and a commitment to improving workflows, provider groups can unlock the full potential of their practices and deliver exceptional care experiences. With the healthcare industry’s transition to value-based care, each provider group has the unique opportunity to lead the way in redefining healthcare delivery and improving patient outcomes. By prioritizing collaboration, empathy, and innovation, provider groups can create a sustainable future that puts patients at the center of care.