How Automated Patient Outreach Technology Closed Care Gaps

Like most healthcare organizations, the Jackson, Mississippi-based Children’s Medical Group faced steep care gaps at the hands of the COVID-19 pandemic. But in a transformation from a purely manual process to automated patient outreach technology, the organization said it’s well on the way to closing them.

“Last year with the pandemic, in April, when everything really started here, our numbers just dropped drastically and we went into an offensive mode of trying to get people to come in for their checkups to try to keep them current on checkups and vaccinations,” Chuck Ray, Children’s Medical Group’s executive director, told PatientEngagementHIT in an interview.

Children’s Medical Group wasn’t alone. In October 2020, a nationwide survey from the University of Oregon reported that 28 percent of families had missed a well-child visit since the start of the pandemic, and another 12 percent missed part of the childhood vaccine schedule.

Seventy-eight percent of families said they missed appointments because they were worried about contracting COVID-19, the study added.

And like many of those other organizations, Ray and his team tackled this problem head-on by sifting through patient information about who was and was not getting in for care. That information would help Children’s Medical Group target patient outreach to make sure kids were getting the care they needed.

But in the bustle of the pandemic’s earliest days, Ray and colleagues needed to do this by hand.

“We did a completely manual process then of printing out these massive paper reports of all these patients,” Ray recalled. “The nurses went through them one by one, and figured out what patients needed, got on the phone, and called them.”

This process kept the ship from sinking, yielding some decent success for Ray and his team. But it was extremely arduous, especially for the nurses who were charged with picking through the data and conducting patient outreach.

“The receptionist took a message, sent that message to a nurse, the nurse then—when they had time—called that patient back, triaged them, digitally created an appointment or not,” he explained. “And that happened on every one of those appointments.”

And that’s not to mention the human error that could occur with a more manual process. Although Ray said he is proud of the work his team did in the early days of the pandemic to prevent and address care gaps, this manual process couldn’t really scale, and some patients were falling through the cracks.

In September 2020, Children’s Medical Group turned to automated patient outreach through health IT vendor Phreesia to streamline this process. The platform enables online patient outreach campaigns both through email and text message that push through directly to patients flagged as needing to fill a care gap.

Within that message, patients can click a link to schedule a well-child visit or a vaccine or any number of other care gaps that may have opened during the pandemic.

Importantly, the tool has allowed Ray and his team to apply any reports they pull about patient demographic cohorts and direct tailored messaging to them.

“One of the great things is that you can target pretty much anything you want to,” Ray stated. “We've targeted things like seventh grade entry. In our state, you have to have a certain vaccine before you can go into the seventh grade.”

“We can look at the kids who are 11, 12, 13 years old, who are going into seventh grade and then send a specific targeted health campaign out that's informing them of that requirement and encouraging them to schedule an appointment to get their checkup and get their vaccine,” he continued. “And it provides a direct link for them to be able to click straight through into our online scheduling portal and schedule an appointment.”

The multimodal approach of pushing these messages out via both email and text message has been essential, especially for a medical group that has not traditionally used email. Although Children’s Medical Group does still use the email feature of the campaigns, being able to use the phone number on file for text message campaigns has been instrumental in ensuring broad reach and family or patient engagement.

Instead, the challenge rests in building out the actual messaging in the campaigns, Ray acknowledged. This is where some family and patient education needs to happen, but Ray said the organization wants to be judicious about not overwhelming families.

“We've tried to create messaging that's effective but not overwhelming,” he explained. “That's the challenge, is you don't want to send out such a large email that they're not going to read it. It's trying to be brief, but effective in those messages.”

Children’s Medical Group relies heavily on provider collaboration, tapping the expertise of its clinicians to ensure patient education included in emails and other messaging is accurate and effective.

“We, over time, have worked together with our staff here to pare those down to what we feel like is the right messaging,” Ray said.

The clinician staff have also worked with the organization’s marketing partners to produce blog posts and other patient-facing messages about the importance of well-child visits, vaccine schedules, and care access.

All of that has required a careful touch as of late. In May, the FDA authorized the Pfizer/BioNTech vaccine for children age 12 and older, making this an imperative for the folks at Children’s Medical Group.

“We started giving the COVID vaccine here to 12 and up and we've done some pretty large campaigns based on that and targeting 12-year-olds and older, and then trying to, again, provide educational material and information about the vaccine and benefits and all those things,” Ray explained.

Ray said his organization needs to be particularly careful when messaging about the COVID-19 vaccine. Back in May, the Kaiser Family Foundation found that only three in ten parents said they’d consent to their 12-year-old getting the COVID-19 vaccine as soon as it would become available. About a quarter said they wanted to wait and see how the shots work in adolescents before their own child gets the shot.

Of course, some parents may have moved out of that “wait and see” cohort, but Children’s Medical Group is in Mississippi, where vaccine hesitancy is a bigger problem.

“Particularly in our state, there certainly is a lot of resistance to the vaccine,” he pointed out. “We're paying the price for that now with our cases skyrocketing. We were definitely more cognizant of making sure that messaging was something that was not too over the top and that would be taken well by either side.”

Their efforts have been fruitful, Ray continued. The organization recently crossed over the thousand-child threshold, a big dent in getting the area’s kids vaccinated.

Much of that can be credited to the automated patient outreach campaigns, with all of the COVID-19 vaccine appointments being booked that way, Ray reported.

Moving forward, Children’s Medical Group plans to use the outreach tools to better understand how its patients interact with the organization and access care. As the organization continues using the tool, Ray said it will aggregate more data that can provide automated patient insights and better tailor campaigns.

Ultimately, this will be better for streamlining the patient access process for both patients and the organization’s staff.

“Another of our big projects is we call in patients in for their annual wellness visit. And so obviously you have to have at least a year or a couple of years’ worth of data to be able to do that,” Ray concluded. “It’s much more online and much more efficient, and that frees our nurses up to actually do patient care instead of being on the phone all day long trying to schedule appointments.”