Community Medical Center (CMC) in Falls City, Nebraska is a 25-bed critical access hospital and multi-specialty rural health clinic that serves a small community of about 4,000 people. They strive to meet a wide range of healthcare needs for their rural community. It’s a very personal mission for the organization and the staff who know every patient by name. After struggling with a high no-show rate and poor patient outcomes, they knew they needed to make a change. They decided to give Solutionreach a try.
Research has shown that larger organizations often have higher no-show rates. These no-shows affect the organization’s revenue as well as the patients’ health. Lack of consistent follow up for patients with chronic illnesses has the same effect. This double whammy of problems was just what CMC was facing a few years ago says Ryan Geiler, advanced clinical applications and analytics director at Community Medical Center.
“Before Solutionreach, we were using a feature in our practice management system for reminders,” says Geiler. “It was very basic, and we were only able to use it for some of our providers. As a result, we had a very high no-show rate of 19 percent overall, and even higher for a couple of specific providers.”
At the same time, CMC was having a problem with managing care for patients with chronic conditions like diabetes. The organization’s A1C “poor control” measure, which is diabetic patients who had an A1C higher than nine percent, was about 50 percent, which is not good, says Geiler.
In 2017, they decided to implement Solutionreach to see if they could make improvements across the clinic for all providers. “The family medicine team and I felt like there were other specialties like dental where they had been successfully using technology like this for years,” explains Geiler. “We love Solutionreach and the benefits we’ve seen over the last two years.”
Those benefits have been substantial. First, the family medicine team reduced their no-show rate by over 80 percent, bringing it down from 19 percent to just over three percent. They’ve done this by offering patients the option to get text, email, or phone reminders and establishing an effective reminder cadence. “We send a reminder when they schedule so they can add it to their calendar,” says Geiler. “Then we send one seven days, two days, and two hours ahead.”
According to Geiler, this has had other benefits as well. When patients do cancel it’s easier to get them rescheduled and they have enough time to try to fill that open appointment. Because they use SR Conversations for real-time, two-way texting, they are also able to quickly answer questions for patients. “It saves time on the phone for staff, but it still feels very personal for patients,” adds Geiler.
The second benefit they have seen is with improving outcomes for chronic disease patients and other value-based care efforts like vaccines. The family medicine team’s first effort was around improving their “poor control” measure with diabetic patients.
Geiler says that they can pull data on diabetic patients who are due to get their A1C levels checked and then text to remind them to make appointments. Since starting that effort, they have gotten the “poor control” measure down from just under 50 percent to 17 to 19 percent.
Next, the family medicine team started targeting preventive care like colonoscopies and pneumococcal vaccines. CMC’s colonoscopy rate was low, at around 22 percent, but since adding recare messaging with Solutionreach, it is up to more than 50 percent and rising. Similarly, the pneumococcal vaccine rate was 50 percent before Solutionreach, and today every CMC provider is between 75 and 85 percent. Now, the family medicine team is looking at how they can improve flu vaccine rates and effectively target specific areas with low vaccine rates. Geiler is combining geospatial mapping with EHR data to see trends in flu cases and vaccination rates.
The other big initiative in the works is getting the critical access hospital up and running on Solutionreach as well. Now that the system has proven itself in the clinic, the team at CMC believe it can have similar benefits in the hospital for patient communication and outcomes.
“Everyone responds to texts,” says Geiler. “Even older patients are on their smartphones and social media. Solutionreach lets us use text to reach patients, and it’s much more effective than using paper or even phone calls. We’re very happy with our decision to add Solutionreach, and we know there is still more we can do to improve the health of our community.”
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