“You’re Dead To Me,” Said The Patient To Their Patient Portal
Today, I received an email that my physician left a message for me in my patient portal. I proceeded to log into the portal only to find I had forgotten my password. l clicked the “forgot my password” link and schlepped through the cumbersome process that is all too familiar. Today, healthcare providers rely too heavily on patient portals to communicate with patients, as Forrester data shows that consumers (76%) are satisfied with receiving medical care or advice via text message.
One of the key trends we see in the healthcare industry is the push towards proactive and preemptive patient care. Providers can (and should) use text messages to support this initiative, to improve patient engagement, and to ultimately drive better patient outcomes. Communication that reaches patients in their moment of need can be a critical factor in preventing an avoidable trip to the emergency room, a life-threatening missed dose of medication for someone with a chronic illness, or even a mental health patient’s attempt to die by suicide. The bottom line: Patient engagement is essential for better outcomes. Notifications that nudge the patient and remind them to take a key action are the most practical vehicle to do so.
What Is Precision Nudging?
At Forrester, we talk to leading healthcare organizations (HCOs) and vendors daily and ask what they are doing to improve patient experience. Among other initiatives, the phrase “precision nudging” pops up in conversations routinely. So, what is precision nudging? Forrester defines precision nudging as:
The act of notifying or sending a message that prompts action by the patient to overcome patient-specific barriers to action at the right time and place for scalable, sustained behavior change.
The Benefits: Precision Nudging In Action
Vendors like CareCentra, Lirio, and Mytonomy are starting to build out precision-nudging capabilities that providers can leverage to deliver proactive communication to patients at their time of need and their location. The benefits are compelling:
- Text messages cost cents. The most effective precision nudges are through text messages. As a result of the pandemic, hospitals are experiencing detrimental revenue decline. With tight budgets, hospitals may lack the capital to invest in technology to enhance patient experience. Luckily, automated text messages cost less than a penny per message; that’s five times less than the cost of a first-class US postage stamp.
- Empathy and trust are elevated. Notifications and messages convey a health system’s concern about patient well-being. Too often, HCOs fall short of patient expectations; they feel left in the dark about their condition and the next steps in their treatment plan. Text messages and precision nudging are quick and reliable ways to deliver critical information to the patient that makes them feel cared for and informed. A vendor we spoke with said, “Precision nudging highlights a health system that is thinking about its patients.”
- Preemptive communication empowers patients to take control. With precision nudging, providers can deliver important information to patients that enable them to take control of their health, allowing them to schedule an annual check-up, access informational resources to learn about a recent diagnosis, or understand new symptoms. Some vendors are building out solutions that use precision nudging to deliver learning and educational modules, like a cooking class for a diabetic patient. In this case, precision nudging can prevent unnecessary visits to the hospital and ultimately drive down the spiraling $4.1 trillion annual healthcare spend. In an era of sweeping workforce shortages, it can help reduce the already-overburdened hospital staff and empower patients to take their health into their own hands.
- Reduction in missed appointments. Missed appointments (no-shows) are costly and operationally inefficient for health systems. In the US, the annual cost for no-shows is estimated at $150 billion. Nudging patients with reminders can help avert no-shows, reduce the administrative burden, and lower costs. One vendor found that a “5-3-1” day reminder ratio works well to remind patients of upcoming appointments.
Start Here in Your Precision-Nudging Journey
Precision nudging is gaining traction in healthcare, and the strengths and opportunities are clear. From our conversations with dozens of vendors and HCOs, we identified two best practices to keep in mind when considering the adoption of precision nudging:
- Focus on high-risk patients. Six in 10 adults in the US suffer from a chronic disease. One of the most impactful ways precision nudging can be utilized is by focusing on high-risk patients and those that face barriers due to social determinants of health (such as many patients on Medicaid). Because of complex conditions and comorbidities, high-risk patients need reminders to show up to multiple appointments, take their medications, and actively participate in their healthcare. There has already been success. CareCentra found that their AI-based precision nudging helps improve medication adherence by 15% and major cardiovascular events scores by 37%.
- Use clear, concise information that patients can act on. We all suffer from too many notifications on our phones and the effects of app fatigue. For precision nudging to function optimally, providers should make precision-nudging messages clear, concise, and actionable for the patient. Include links to more information or next steps, such as a link to a web page with information on a condition or a link to schedule an appointment.
Patient experience is a key tenant of the quintuple aim (in case you’ve missed it, we have expanded past the quadruple aim to include health equity), and precision nudging is the quintessential piece of the puzzle. But for organizations to be successful, they must develop a comprehensive technology strategy. At Forrester, we’re diving in to enable our clients to make informed purchasing decisions and develop their tech roadmaps. In a few weeks, we’re kicking off a new report on the top five technology segments needed to power the next-generation patient experience, and we will be talking to some of the top providers and software innovators in this space. If you are (and you should be) building a strategy to improve patient experience or if you are developing a technology that targets this space, we would love to speak with you via inquiry or briefing.