Using a virtual triage platform to boost patient access
Community Health Network partnered with DexCare to simplify patient access, improving appointment booking and patient experience through a virtual triage platform.
The simple act of seeking and connecting with healthcare providers can prove daunting in America, where various factors, including location, availability, cost and insurance coverage, play critical roles in healthcare selection and utilization. The onus is on healthcare providers to facilitate easy and convenient appointment booking for new and existing patients. With advanced virtual tools, healthcare providers have the capability to simplify and streamline the process of seeking care.
Indianapolis-based Community Health Network partnered with DexCare in April 2021 to accomplish this goal.
"We've always been leaders in this digital space when it comes to these concepts of consumerism," said Patrick McGill, M.D., executive vice president and chief transformation officer with Community Health Network. "I feel like we were talking about consumerism and thinking about this long before it became kind of the hot topic…. So, our goal, or motto, or our brand promise, really, is exceptional care, simply delivered. So, once we get people in the door, that's that exceptional care. But really, how do you get people? How do you attract people? How do you get them scheduled? How do you get them connected with a provider?"
Data from the Peterson-KFF Health System Tracker shows that, in 2022, about one in five U.S. adults under 65 experienced at least one care access barrier aside from cost. These included difficulties finding an available appointment and getting to the provider or clinic when they were open. Another survey released in 2023 revealed that more than 40% of U.S. adults faced what they considered "longer than reasonable" wait times to obtain an appointment. About 26% reported waiting more than two months for an appointment on the books.
Health systems must make finding and booking healthcare services seamless and convenient to ease access to healthcare and boost patient attraction and retention. Community Health Network's digital health partnership with DexCare has been successful in this aspect; however, the health system first had to gain provider buy-in and overcome operational challenges.
Understanding the digital health partnership
In the internet age, search engines like Google are critical entry points to the healthcare system.
"You need a hairdresser, go search Google, you need to get dinner, search Google," said McGill. "Even if you know what you want, you start at Google to find the phone number for your restaurant or whatever it might be. And so, we knew that healthcare consumers were doing the same thing, and we needed a way to capture and connect that Google search [to the health system]."
Though Community Health Network offered online scheduling and other appointment booking tools through its Epic MyChart patient portal, he added that few healthcare consumers were using that channel. Even established patients who had initially used the patient portal to book appointments tended to go back to Google to book subsequent appointments.
So, as people were trying to navigate -- Should I go to virtual care? Can I get an appointment in virtual care? Should I go to urgent care? -- we needed a better way to have this kind of seamless experience for the booking. And I think oftentimes we have some great digital tools, but they're siloed in single channels.
Patrick McGill, M.D.Executive vice president and chief transformation officer, Community Health Network
Also, the health system has numerous avenues through which healthcare consumers can receive care, from urgent care clinics to telehealth to retail clinics at Walgreens.
"So, as people were trying to navigate -- Should I go to virtual care? Can I get an appointment in virtual care? Should I go to urgent care? -- we needed a better way to have this kind of seamless experience for the booking," McGill said. "And I think oftentimes we have some great digital tools, but they're siloed in single channels."
The partnership with DexCare was born out of a longstanding relationship with Providence, which developed the digital care access platform in 2016. DexCare spun out from Providence in 2021, the same year Community Health Network implemented the solution.
"We had this relationship with Providence, and they had developed a solution, and it just happened to be that we were trying to solve the same problem with this consumer experience," McGill noted. "And at that time, there really wasn't a competitor solution on the market. So, doing the market scan was pretty easy because DexCare was the only solution. I still would argue to some degree or to a [high] degree, DexCare is still unique in what they do for us and for other health systems."
The platform is designed to orchestrate demand and supply across all lines of care, Derek Streat, CEO of DexCare, said. Healthcare consumers can use the platform to explore their care options and availability of services, schedule in-person and virtual appointments and understand their health plans and insurance eligibility. Healthcare provider organizations can utilize the solution to unify patient data, track and manage a network of clinicians and locations, capture new patients and assess healthcare utilization and patient volume patterns.
"What we're doing is we're trying to get an understanding of patient intent and motivation, what they're looking for, what they need, what their history is, get an understanding of what's going on with providers," Streat said. "Some stuff's pretty basic but hard to get at -- a lot harder than you would think. Things like who's available right now, in real time, but then some more complicated things like who actually has the capacity and who can service these patients the best and in what way?"
What we're doing is we're trying to get an understanding of patient intent and motivation, what they're looking for, what they need, what their history is, get an understanding of what's going on with providers.
Derek StreatCEO, DexCare
Through data analysis, the platform can recommend providers, care settings and service lines that match patient needs and provider capacity. Streat added that helping patients find the right level of care frees up more experienced clinicians to handle complex cases.
Not only that, but Streat noted that the company helps health systems create and launch websites that load quickly and integrate one-click scheduling into local listings to ease care access.
According to McGill, the company has helped the health system to create a seamless process for patients seeking healthcare services, providing multiple capabilities that make it easier for healthcare consumers to find and receive care.
"Are there solutions that we can [use to] surface appointments? Absolutely. Are there solutions that can do search engine optimization? Absolutely. Are there solutions that can help us on the backend with capacity management? Absolutely. But is there a solution that brings all three of those together? Not that I'm aware of…. And I think that's the secret sauce that DexCare brings to the table," said McGill.
Platform implementation and results
Following the technology selection process, Community Health Network leaders worked to gain provider buy-in. They talked with the clinical and administrative staff to allay their concerns and ensure they understood that the technology would ease their current workflow issues rather than add new ones.
"You have got to get provider buy-in about: What are you going to do to my schedule? Are you going to offer up visits that I don't want you to be offering up? And those types of things," McGill said.
To gain and maintain buy-in, the health system's leaders also had to ensure that there were no gaps in the technological infrastructure. For instance, McGill highlighted that with patients scheduling through the DexCare platform, the risk of creating new EHRs or charts for established patients rose. So, the organization had to develop patient-matching protocols to verify that they accurately identified new versus established patients.
The health system has now moved on to developing more complex processes, such as proactively connecting patients with preventative healthcare. McGill and Streat shared that the organizations are now working on pathways that would prompt someone booking a primary care appointment to also book a mammogram appointment if they are overdue.
"As people are coming into these low acuity settings -- it could be a retail clinic, it could be a virtual visit -- there's a not insignificant number of people where there's something there that makes it worthwhile to get a screening done or some additional work looked into…. At a certain age, we should all do these kinds of things for good prevention. And what I am really excited about with that program as we continue to evolve it is that, at the end of the day, that's real access that will save lives," Streat said.
The platform has resulted in meaningful improvements to capacity management. According to McGill, the virtual care team increased its appointment bookings by 300% since 2021, with bookings coming from all over the state.
"If you look at the beginning of DexCare, it was localized to central Indiana," he said. "When you look at it now, that heat map covers the entire state right up to the border. And the reason it doesn't extend past the border is just from licensure and where we practice."
The platform has boosted patient volume by expanding the health system's footprint without adding new brick-and-mortar facilities or providers, McGill added.
Streat further noted that the health system's repeat patient percentage is over 50%, meaning that more than half of the patients who use the platform for care access return. This is a significant metric in an era where people aren't likely to stick to one healthcare facility.
"People want convenience and speed and their problem addressed, and they'll go out online, and they'll search for something else pretty easily here," Streat said. "So, you've got to be out there and continue to compete for that patient, even if they are already one of your patients."
Ultimately, the health system is responsible for the patient's healthcare journey. In the ever-evolving landscape of healthcare consumerism, this includes connecting new and existing patients with the right level of care at the right time. Once connected, the health system can work to ensure a seamless experience that will bring them back.
"When people come through the virtual care door, and they have a great experience, they come back for oncology, they come back for cardiovascular [care], they come back for women's care, they come and establish primary care with a primary care physician," McGill said. "So, it [leads] to this kind of snowball effect of get them in the door, deliver a great experience, make it frictionless, and they'll come back for everything else."
Anuja Vaidya has covered the healthcare industry since 2012. She currently covers the virtual healthcare landscape, including telehealth, remote patient monitoring and digital therapeutics.
