Using intelligent automation for digital patient intake engages patients and supports staff

While the needs of patients and staff have historically been considered separately — or even in competition with one another — patient and staff complaints often boil down to the same root cause: healthcare workflows are inefficient and difficult to navigate. Patients endure long wait times. Staff are collapsing under the weight of administrative burden. Patients want to have more time with their provider. Staff want to spend more of their time on patient care. At their root, patients and staff share the same mutual frustrations.

Consumerism is transforming healthcare delivery. Patients are increasingly expecting healthcare to catch up to other industries, to provide a smooth and intuitive digital experience. 57% of patients say other industries are better than healthcare at providing a personalized experience across channels. 80% of patients would prefer to communicate with their healthcare providers digitally. A 2020 study found that over half of patients would rather endure other typically frustrating experiences, such as waiting at the DMV or jury duty, rather than deal with a health insurance issue. 

Health system executives have historically resisted digital transformation — but with such avenues as online reviews, patients have become more knowledgeable and more vocal about their choices and preferences. The patient experience — and patient satisfaction — cannot be ignored.

The pandemic acted as an accelerator for digital preferences. Through the pandemic, we’ve seen that patients have been increasingly using virtual visits and adopting technology in their healthcare experience, and this is unlikely to revert to pre-pandemic levels. Patients don’t want to sit in doctor’s office waiting rooms or touch clipboards and pens that other patients have used for fear of contamination, and 41% of adults have delayed or avoided medical care due to fears about COVID. 

At the same time, the healthcare workforce is top of mind as the labor shortage rages on. Prioritizing the patient experience at the expense of staff would prove counterproductive after more than half a million workers left the healthcare sector last year. In this climate, the patient experience can’t be improved by adding more staff. Instead, health systems must prioritize alleviating employee burnout while creating a better patient experience.

In order to achieve the dual mandate of simultaneously engaging patients and staff (see our webinar with Fort HealthCare on this topic), health systems will benefit from automating the manual workflows that serve as a barrier to growth. 

Automating routine tasks allows staff to focus on the more meaningful work of patient care and human connection–leading to more satisfaction all around. 

Solving for patients, staff, and providers

Both patients and staff appreciate convenience, ease of use, and efficiency. This is backed up by the research, which also reveals some surprising relationships between wait times and the overall perceived quality of patients’ care. 

It’s self-evident that long wait times negatively impact patient satisfaction scores. But long wait times have wider-reaching impacts across all metrics, including how highly patients rate the quality of their care and their confidence in their providers [see this study]. 

Patients’ ability to trust their providers is an important aspect of quality care. If they lose trust in their provider, patients may be less likely to listen to provider recommendations or forgo care altogether. The study “Wait Times, Satisfaction Scores, and the Perception of Care” concludes, “Thus, we are led to believe that wait times are not just a component of patient satisfaction, but an important component of quality care. In a new healthcare economy, minimizing wait times must be taken seriously in order to compete, manage costs, and retain clientele.”

When patients are dissatisfied, they are more likely to leave negative reviews or leave the practice entirely. This issue with patient retention isn’t just a business concern — it also has a negative impact on patients. The study “Patients’ time perception in the waiting room of an ambulatory emergency unit: a cross-sectional study” pointed out, “There is evidence of a reciprocal relationship between patient satisfaction and continuity of care, which is associated with improved patient outcomes.” If patients are dissatisfied with their healthcare experience and continually switch providers in pursuit of a better experience, their health outcomes may suffer as a result of this lack of care continuity. 

It is also well known that healthcare staff burnout is tied to a sense of meaningfulness — this is a helping profession. Workers burn out when they feel disconnected from that sense of purpose. When staff spend most of their day copying information from paper forms into the computer instead of contributing to patient care, it’s hard to connect to that sense of meaning. 

With the strains of the pandemic added to the extremely high documentation burden, staff simply can’t keep up. Burnout has been a building problem for many years, even prior to the surges of COVID, but the extra weight of the pandemic exacerbated existing issues. Many left. The remaining staff who worked through the pandemic are psychologically scarred in a way no meditation app can fix. One article from The Atlantic published last year states, “America’s medical exodus is especially tragic because of how little it might have taken to stop it.” But now that we’re here, each staff resignation ultimately means more work for the staff who remain. 

If ever there was a time for “work smarter, not harder,” it’s now. 

Automation is the solution 

Automation can address all of these pain points. It’s possible to speed up patient check-in times in a way that is easy and convenient — for both patients and staff. And automation can elastically scale to handle suddenly increased volume, unlike human staff. 

Notable’s approach to patient intake has been to text and email patients their pre-visit forms in advance of their appointment. The patients can fill out these digital intakes at their own convenience, from their phones or on their computers. The information is placed automatically into the electronic health record, so staff don’t have to do the repetitive work of data entry. Patients appreciate the ease and convenience of the process. Staff appreciate the time savings, with some even saying they “would prefer this for [their] own care.” 

Automating patient intake reduces check-in times for patients and increases patient satisfaction. Intermountain decreased patient check-in time by 25% after starting Notable digital intakes, and adding a barcode-enabled, touchless check-in process for those who had already filled out their forms. At the same time, the new automated process saves 30 minutes per day per medical assistant. At ARC, providers were able to decrease their documentation time by 45% by using the digital intake functionality to populate the patient history portion of progress notes. 

Each time a patient completes their pre-visit paperwork through Notable, we ask them for their feedback. Their feedback speaks for itself: 

“Digital is so much better than touching a pen and paper at the office. Plus I'm done before I get to the office, which is faster for me to get in and out. I think that helps us all!”

“Forms were straightforward. In many cases, information already in the system was prepopulated, making forms easier to complete. It was clear how many forms I had to complete and when each was done.”

“Dummy Proof.”

“Easy, even for an old guy.”

Of note, several of these pieces of feedback, gathered from patients of a variety of ages, mention ease of use and understandability. Notable has found that it's important to approach the patient with simple, natural language and an intuitive design. In order to get the most patients to complete their pre-visit forms, the process has to be simple and easy to understand. In our work with Lowell Community Health Center, which serves a diverse patient population, 40% of whom are not native English speakers, we were able to use these principles to increase patient engagement by 30%. 

Several other pieces of feedback mention convenience and speed. Patients are increasingly evaluating their care options for convenience, in addition to quality of care, and are more likely to find another provider if their expectations are not met. To match patient expectations, Notable pre-populates known information from previous encounters so patients don’t have to do redundant work; they simply verify that the information presented to them is correct. 

Notable believes that patients, staff, and clinicians are all key stakeholders, and any digital solution should be designed to offer a superior experience to all parties. We recommend starting with these key take-aways when implementing digital patient intake solutions. 

Key take-aways for successful digital patient intake implementation

• Learn from patients and staff about their existing pain points. Use existing feedback channels like patient exit surveys or staff meetings to take note of common themes. Check studies that have been done on the impact of these patient and staff satisfaction metrics.
• Design solutions that address root causes of issues. For example, to eliminate friction during the check-in and registration process, using automation can both reduce patient check-in times and eliminate data entry work for staff during check-in. 
• Prioritize ease and convenience. The interface should be intuitive and the language should be easy to understand for patients. The new workflow should reduce staff workload, not add to it.
• Seek inspiration from other industries when designing consumer experiences. Since ease and convenience have become so important to patients, consider examples outside healthcare of seamless experiences, and re-imagine how your own processes might eliminate friction.
• Treat patients, staff, and clinicians as key stakeholders. Adding a digital solution should improve everyone’s experience, not add administrative overhead. Patients, staff, and clinicians should all find the process improved by the new solution. 

To learn more about the strategies we use to design our intake solutions, check out this whitepaper.