How Intelligent Automation Can Help Close Care Gaps, Boost Patient Outreach

July 08, 2022 - In the US, access to and quality of healthcare are major drivers of health disparities and widening patient care gaps. Bridging care gaps also requires providers to have access to knowledge and resources to support these efforts, which can prove difficult in the wake of the COVID-19 pandemic and ongoing healthcare staff shortages.

To combat these difficulties, some healthcare providers are turning to intelligent automation. Automation is a trending topic within security and revenue cycle management, but HealthITAnalytics sat down with Todd Beardman, MD, chief medical information officer, and Kristen Guillaume, chief information officer, at North Kansas City Hospital to discuss how the health system is harnessing intelligent automation to bridge care gaps for patients.

IDENTIFYING OPPORTUNITIES FOR AUTOMATION

To effectively utilize intelligent automation, providers must first identify their use cases. During the pandemic, North Kansas City Hospital set up COVID-19 vaccination clinics but found no good way to contact patients and get them signed up for vaccinations. To close this gap, the hospital partnered with intelligent automation company Notable to automate vaccine clinic enrollment.

From there, the partnership expanded to address issues related to staffing shortages, such as online scheduling, pre-registration, and medical assistant intake, which all play a significant role in closing care gaps.

“The way I look at that is just trying to think about the people that we don't have come through our doors that we're still responsible for, and they need their care gaps closed,” Beardman stated. “That's really how we're using [intelligent automation], as a safety net for patients that are behind. Through the pandemic, everybody's behind, right? People haven't gotten their colonoscopies. They haven't gotten their mammogram. They maybe haven't had an A1C for their diabetes [assessed] in too long, or they didn't get their diabetic eye exam. That's really the crux of how we use the Notable services today.”

Guillaume noted that in addition to closing care gaps, intelligent automation has supported the hospital’s consumer strategy by promoting ease of use and access to care for patients, leading to higher patient engagement and more successful outreach initiatives.

TAILORING AUTOMATION BASED ON CARE GAPS

After identifying care gaps and related potential use cases for intelligent automation, providers must tailor that automation to fit their specific needs and the needs of the population they serve. At North Kansas City Hospital, this process begins by pulling clinical and scheduling data to identify patients who may experience widening care gaps.

Breast cancer care gaps are one example, Beardman said. When pulling clinical and scheduling data, the hospital can flag patients based on multiple factors that can create a breast cancer care gap: does the patient need a mammogram? Did their doctor order a mammogram, but the patient didn’t go? Does the patient have a diagnosis of breast cancer? Do they have a procedure history of mastectomy? Do they have a future appointment for a mammography or other breast cancer evaluation?

That information is then filtered through the intelligent automation system, which uses it to perform patient outreach and set up a line of communication between patient and provider. From there, the patient can directly schedule any necessary appointments or let the hospital know if they’ve received that care elsewhere so their records can be updated.

Beardman further added that the hospital also uses this approach for colonoscopies, which are the gold standard for colon cancer screening, but many patients don’t want to have the procedure. By analyzing the clinical and scheduling data of the patients, the hospital has more flexibility to offer them other options for colon cancer screening. These tests may not be as good as a colonoscopy, but they provide an opportunity to close a care gap that may be left open or widened if the patient had not been offered colonoscopy alternatives.

BUILDING SAFETY NETS AND FOSTERING PATIENT ENGAGEMENT

By addressing some of the issues that can lead to worsening care gaps, such as staffing shortages, intelligent automation can help providers create safety nets for patients.

“It's very hard for us to have staff available to make these outreaches, to make phone calls, to send letters,” Beardman noted. “I know it was happening, but not at the level that we needed it to happen. So, I think that's the biggest trend I've seen is that we're actually getting that message out. We're seeing people engage with us in that digital experience and book appointments, which is fantastic because these are people that, otherwise, they didn't have the care gap closed.”

Increasing patient engagement and appointment scheduling without increasing burdens on existing staff has been a major success for North Kansas City Hospital — one that the organization could not have effectively achieved without intelligent automation, according to Guillaume and Beardman. Because it no longer relies on clinical staff for outreach and scheduling, the hospital is more resistant to general issues across healthcare, such as staff turnover and clinician workload.

These can also create hurdles to consistent patient outreach, but intelligent automation makes it so that outreach performance, tone, and selection are both predictable and repeatable, Beardman stated.

This makes outreach easier on the provider side and improves the experience on the patient side. Since outreach is automated, Beardman said, “The patients get a fantastic message every time. They don't get me if I'm grumpy and tired and say, ‘Well, you're due for your mammogram.’ That doesn't happen.”

He also noted that automated outreach means patients get these communications on their own timetable, and they can engage at a time that is convenient for them, which has been a major driver of the success of the hospital’s outreach program. The hospital has also seen success with automating some of its information-gathering efforts, such as depression and postpartum depression screenings, along with social determinants of health (SDOH) questionnaires. Since these are difficult topics, patients seem to prefer to share those details online rather than in person, and making these screenings available online can lead to better information gathering, Beardman said.

In the future, North Kansas City Hospital hopes to expand its intelligent automation efforts to include return-to-clinic reminders, a vital aspect of the safety nets that keep patients from experiencing a care gap. If patients don’t book a return-to-clinic appointment, the hospital hopes to be able to run reports that flag those patients and send out automated reminders for them to do so.

Throughout the hospital’s intelligent automation journey, patient engagement has been relatively consistent across age groups and demographics, in contrast to some concerns that certain populations would not engage with digital outreach. Guillaume and Beardman shared multiple examples of patients in their population who had shared positive feedback about the automated system, including a couple in their 80s and one woman who is blind.

These results are a strong statement in support of the usability of intelligent automation in healthcare, they agreed.