CHICAGO — The methods seem simple: calling patients after discharge to see if they have any questions, or having them watch a video prior to a visit to help calibrate expectations. The results have been profound for one Ohio health system: fewer readmissions and huge cost savings.
We all know there is a growing body of evidence that patients who don't stick to their prescriptions is a big problem in more ways than one. Some estimate that almost 75 percent of patients have admitted that they don't take their pills as directed, and that could amount to about $105 billion in avoidable costs to the health care system each year. And, of course, skipping your meds can also lead to a costly readmission to the hospital, and the corresponding penalty from CMS.
Summa Health — a seven-hospital system out of Akron, Ohio — is looking to reverse that trend, Carmen Natale, system director of service excellence, told attendees at the ACHE 2014 Congress Wednesday. Rather than just releasing patients into the wilderness, they've made a concerted effort to have registered nurses call following discharge, ensuring that they understand instructions and filled their prescriptions.
It sounds like a no-brainer, but took some convincing of docs and execs alike.
"A lot of people hear the term patient engagement or patient empowerment and they think it's easy," Devin Gross, CEO of Emmi Solutions and partner in the effort, told attendees. "They think I'm just going to say it and sprinkle [fairy] dust and it's going to get out there. … You need that executive support. My one [piece of] great advice is to make sure the execs are behind you, make sure physicians are behind you."
As an aside, I also spent a few minutes Wednesday with the Orca Institute's Kathleen Bartholomew, R.N., author and health care culture expert, talking about engaging staff and calibrating your organization so the patient is the central focus. Here's the video:
Summa is engaging patients at the front end of the encounter, too, through the use of video. Rather than inundating visitors with paper and wasting physicians' time with a barrage of repeat questions, they, instead, play a short, Web-based clip that answers common queries and helps to frame their expectations.
The patient can be one of the biggest variables during a visit, Natale says, and the health system wanted to find a way to encourage them to ask questions, raise concerns and feel empowered to take action.
"We're asking for their help in this, and I think that's an important thing," Natale says. "Not elevating expectations, but managing them. It's not just a one-way street. We can't just provide everything to you; you need to be empowered and feel comfortable engaging with us. Because, ultimately, when you have that two-way relationship, those are the most satisfied patients."
The ROI on the effort has been meaningful thus far. Some 78 percent said the program increased their confidence to ask questions, and 90 percent said they will take new action in managing their health. Satisfaction survey scores have increased from patients in the program. And readmissions tied to the discharge follow-ups have dropped by a couple of hundred cases, Natale said. It doesn't seem like a ton, but 200 fewer readmissions at an average cost of $11,200 is north of $2 million in savings.
The next step for Summa, Natale says, is finding a way to connect all these disparate forms of communication with the patient to form what he calls a "relationship map." While we're on the subject, I'm also working on the second part of our ongoing series about patient engagement. You can check out the first here. The second installment will focus on engaging patients at the individual level. Please drop me a line at 312-422-2605 or email if your hospital is doing something unique in that regard, and watch for the story in June.