ADVANCE FOR HEALTH INFORMATION EXECUTIVES - Until now, implementations of self-service technology in the health care setting have primarily been driven by operational and financial objectives. And while the cost savings and increased efficiencies that self-service provides are significant, check-in kiosks and patient portals provide a number of clinical benefits as well. More specifically, these tools empower patients and equip physicians with the information needed to address gaps in care, when leveraged in combination with targeted applications such as prescription adherence management and clinical decision support.
The right information at the right time
One of the major advantages of self-service is that it captures patient information in an electronic format from the very beginning of an encounter, facilitating a seamless flow of patient data and ensuring that providers have the information needed to proactively address issues affecting outcomes at the point of care.
One of the major advantages of self-service is that it captures patient information in an electronic format from the very beginning of an encounter, facilitating a seamless flow of patient data and ensuring that providers have the information needed to proactively address issues affecting outcomes at the point of care.
In addition to gathering demographic, insurance and health history information, kiosks can also collect triage information, such as the chief complaint details for the visit. All data provided is immediately available in the patient's electronic record, giving clinicians at-a-glance access to this critical information prior to entering the exam room and minimizing burdensome data entry into the electronic medical record or chart. As a result, physicians are able to ask fewer routine questions during the patient visit, enabling them to devote more time to addressing specific patient concerns and expediting the care process.
Kiosks also help providers make strides with regard to prescription adherence by consistently polling patients on medications taken, the dosages and any side effects experienced. Unlike traditional programs that target patients at home, kiosk-based medication adherence initiatives provide a unique opportunity to engage patients during the care episode when immediate action can be taken.
For example, targeted applications for converting patients to generic or mail order prescriptions can be deployed to patients during check-in based on specific demographic, geographic and membership criteria. Then, if a patient indicates he has stopped taking a particular medication for financial reasons, he can quickly review cost-saving options via the kiosk and switch to a mail order or generic version of the drug through direct connections to the appropriate pharmacy benefit manager (PBM) or payer.
Meanwhile, any changes are automatically forwarded to the provider in an electronic format, triggering an alert to generate an updated prescription that meets the new parameters; a mail-order prescription for a 90-day supply, for instance. By managing workflow this way, providers can minimize time spent managing prescription-related issues.
This is a major advantage, considering that the average staff member spends more than 23 weeks per physician per year on administrative interactions with health plans1. Since much of this time is devoted to dealing with formulary-related tasks, an electronic workflow for managing these duties eliminates the need for frequent phone calls and faxes with health plans and gives staff more time to devote to patient care.
Offering less expensive and more convenient medication options helps to reduce health care costs as well. In fact, recent studies estimate that $290 billion in avoidable medical expenses could be saved each year through improvements in medication adherence2.
If patients are non-compliant with their medication regimens due to side effects, lack of effectiveness or lack of information, clinicians can be immediately alerted to offer an intervention that will promote compliance and ensure better outcomes. Forgetful patients can be offered free medication reminder services and patient education on their medications and/or conditions to reinforce physician instructions.
Coordinating more comprehensive care
With self-service technology in place, providers can also enhance their clinical decision support capabilities for optimum evidence-based guideline compliance. By aggregating all patient information captured via the kiosk with EMR and claims data, and running clinical decision support tools against this data in real time, self-service users are able to better identify gaps in care, such as potentially dangerous drug interactions or care recommendations that are long overdue. When issues are identified, a real-time alert is automatically sent to the provider so that they can be addressed during the patient visit.
With self-service technology in place, providers can also enhance their clinical decision support capabilities for optimum evidence-based guideline compliance. By aggregating all patient information captured via the kiosk with EMR and claims data, and running clinical decision support tools against this data in real time, self-service users are able to better identify gaps in care, such as potentially dangerous drug interactions or care recommendations that are long overdue. When issues are identified, a real-time alert is automatically sent to the provider so that they can be addressed during the patient visit.
Even providers without an EMR system in place can take advantage of the clinical decision support capabilities that self-service offers, and the resulting data can be used to collect monetary bonuses available through pay-for-performance programs. Plus, self-service is a patient-facing technology that provides a more accurate picture of a patient's actual compliance with recommended care guidelines. As such, it is better suited to identify gaps in care that may otherwise go unnoticed.
The patient-facing nature of the technology also offers an opportunity to direct patients to educational materials and resources for better managing their health. For example, a diabetic patient that is overdue for a yearly eye exam may be given the option to automatically enroll in a chronic disease management program offered by their payer. By connecting patients with resources to better manage chronic conditions and maintain a healthy lifestyle, providers can empower patients to be more active participants in their own care and improve outcomes.
As self-service technology becomes widely available with minimal to no cost to physicians, these systems stand to gain mass adoption across all segments of health care. By offering a high-touch way to establish an ongoing dialogue between patients and their providers, self-service builds a foundation for improved compliance and clinical decision making. The end result is happier, healthier patients.
Mr. Toleti is chairman of PatientPoint, a provider of patient-facing self-service solutions. He can be reached at rtoleti@patientpointkiosk.com.
1. L. P. Casalino, S. Nicholson, D. N. Gans et al., "What Does It Cost Physician Practices to Interact
with Health Insurance Plans?" Health Affairs Web Exclusive, May 14, 2009, w533-w543.
2. New England Healthcare Institute, Thinking Outside the Pillbox: A System-wide Approach to Improving Patient Medication Adherence for Chronic Disease (2009).
