Develop Physician Practice Relationships for Better Patient Care

Business Value Follows
Chip McCoy, Clinical Systems Analyst, Baptist Health of Northeast Florida

As a personal ambassador for Baptist Health, I have the opportunity to build lasting relationships with physician offices and include them in our Circle of Care. When I go out to help offices improve their success communicating with our hospitals, I don't think in terms of bottom line dollars. I believe that where healthcare is "supplied," the demand for services will follow. My goal is to provide healthcare to healthcare providers by following our mission statement: “…to continue the healing ministry of Christ by providing accessible, quality healthcare services at a reasonable cost in an atmosphere that fosters respect and compassion.”

I can fulfill that mission by working with office managers and physicians to improve their workflow processes and taking advantage of tools such as Order Facilitator^®. Tools such as this create efficiencies for the physician offices and the hospital. By treating the offices as “family” in a sincere fashion, that efficient relationship becomes a longstanding one.

In nearly 300 physician offices I’ve visited over the past three years, two primary concerns have been expressed:

1. How to take advantage of hospital services in the most efficient way, and
2. How to get patients to actually get the prescribed hospital tests necessary to diagnose and treat them, thus providing them the best possible care.

Baptist Health sees the downside of these issues every day in a number of outpatient no-shows that waste valuable resource opportunities. This also means that some patients won’t receive the treatment they need.

How physician offices order patient tests:

It’s been my experience that physician offices have three basic workflows to order hospital tests for their patients:

1) Wait while I call; 2) Let me broker a time for you; and 3) Take this slip of paper--none of which have proved particularly satisfactory or successful. An enlightening examination of these methods serves to show the impact they are having on their two primary concerns.

Three basic methods physician offices use to order hospital outpatient tests: Wait while I call. In this case the patient stays in the office until the office schedules an appointment for the prescribed test or procedure. Many times the caller must wait on hold. As the appointment is being scheduled with the hospital, the patient is consulted for convenient times. When the call is completed, appointment details are handed to the patient. While this is the most productive method of the three, it’s not without its problems. The patient waits, the caller waits, other patients wait and still some of these appointments will result in no-shows. Let me broker a time for you. This scenario hides a common drawback. For this method the patient is free to leave, since the office staff offers to schedule the necessary appointment for him or her. Someone finds time to call the hospital and endures the customary on-hold before securing a slot in the hospital’s schedule. Then the office must notify the patient of the appointment, and all too frequently hears: “I can’t make it that day.” At this point, it becomes the patient’s responsibility to re-schedule with the hospital. The office can only hope the appointment is made and kept – without really ever knowing if it was. This generates more phone calls and the office (and hospital) may still be dealing with a no-show. Take this slip of paper. This is the most deceiving scenario in terms of perceived time saved for the physician office. The office gives patients a signed written order and asks they contact the hospital for an appointment. Sounds simple, right? But what happens if the patient forgets, loses the paper or just doesn’t want to schedule? No healthcare happens. Sometimes the patient can’t articulate the order details to the hospital, in which case the patient or the hospital is required to contact the physician office for clarification. In this case, a phone call is still required between the office and the hospital, only further delayed. In the former case, the office still doesn’t know if the patient was willing to continue care and, many times, fostering a no-show situation for the office.

The main problems embodied in each of the three workflow methods are disconnects between and among the parties. Communication is either absent, late, incorrect or incomplete, leaving a vulnerable gap in care delivery decision-making that does nothing to alleviate the two primary concerns of office managers.

Improving the ordering workflow process:

Because I consider physician offices part of the Baptist Health family, I get to ask a lot of pertinent questions as I develop our synergistic relationship:

• Is your current ordering workflow really easier, or does your method often come around to affect you later?
• How many times does the patient call you back?
• How often do you get calls from the hospital?
• How long are you on the phone with each call?
• Do you spent time re-faxing orders?
• How often do your patients miss their appointments?

And then, when they know I truly understand their point of view, I hint at the solution they seek with my two final questions:

• How would you like to communicate your hospital orders in less than three minutes?
• How would you like to know that your patients follow through with the care they need?

I’m there to support office staff on how to communicate with our hospitals—electronically. I do the “healthcare math” with those that are resistant to change. I literally add up the minutes they currently spend ordering tests and compare the total to the three-minute process they would employ if utilizing Order Facilitator over the web. I seem to always gain family members this way.

Using Order Facilitator adds to the family feeling:

Baptist Health offers community physicians free use of SCI Solutions’ web-based Access Management capability, Order Facilitator, to simplify scheduling their outpatient tests and procedures with our hospital. It’s a key component of our relationship building program.

I adapt according to how each office likes to work and accommodate their processes to take best advantage of this scheduling tool. So when a staff member enters a patient order, it’s quick and intuitive. All information is complete, including the physician’s signature before online submission. The system verifies the order for Medical Necessity, automatically distributes it to our pre-registration and ancillary departments, and sends instant confirmation to the physician’s office. Then prior to the appointment and after payment authorization, the system generates an automatic patient reminder. Our organization goes a step further: a member of the Baptist Physician Liaison Team always contacts the patient to address any unexpected barriers that might keep patients from their appointments.

Conclusion:

Patients benefit from more proactive care delivery with less waiting. Offices save time with the right order processing efficiency and hospital communications. Baptist Health enjoys stronger physician loyalty and increased volume in services. Everyone in the family benefits from the greatly reduced number of no-shows. And I am satisfied that I fulfilled our Baptist Health mission to continue the healing ministry of Christ by providing accessible, quality healthcare services at a reasonable cost in an atmosphere that fosters respect and compassion. My success here is real and invaluable as I witness the direct impact on delivery of the best possible healthcare to my community.

Premise:

Improving customer service for community physicians improves hospital success

Facts:

• 92% of patients are loyal to their physician, rather than a hospital*
• On average, a single physician generates $1.5 million annually in hospital revenue**
• 100% of hospital revenues (except ER) are associated with a physician***
• All else being equal, community physicians choose a hospital because of its service***

*Source: Harvard Business Review
**Source: HFMA
***Source: Studer Group

Conclusion:

Improving physician office efficiency has a direct correlation to hospital success through:

• Increased patient volumes
• Improved revenues
• Decreased outpatient no-shows
• Ability to advance mission of serving your community

Baptist Health of Northeast Florida includes five hospitals: Baptist Downtown, Baptist Beaches, Baptist Nassau, Baptist South and Wolfson Children's Hospital. Along with a primary care network, a home health agency, a pharmacy network and other services, Baptist Health serves the Northeast Florida and Southeast Georgia region.

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client quote:

“With SCI we reduced our lab monthly denials from $23,000 to 0, and increased utilization from 400 average orders a month to 3,230, as well as improved patient, physician and staff satisfaction.”

Eisenhower Medical Center

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