Effective Strategies to ImproveAccess and Continuity

Kelly Aardema, CPC+ Learning TeamBetty Sanchez-Catanese, MD

Mark Hinman, MD, Hinman Family Medicine

Agenda

1. Access and Continuity in CPC+

2. Practice Strategies: – Betty Sanchez-Catanese, MD– Mark Hinman, MD

3. Audience Q&A and Discussion

4. Resources and What’s Next

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Access and Continuity Strategies

Access and Continuity

• Dedicated appointment slots for physicals

• Expanded office hours• Providers rotate same-day

appointments

• Group visits for behavioral health• In-person equipment tutorials for

remote monitoring• Patient education signs and

posters regarding access to care options

• Direct messaging to patients through portal

• Patient feedback on brochures and posters

• Improving phone systems and response times

• Relationships with counseling groups that come into the clinic

• Curbside care and labs• Telehealth implementation

Group Visits/Education

Same-Day Appointments Adapted Access

Patient Engagement

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Quotes on Access

Norma Meccay (Amherst Medical Associates)• “We currently have 53% of our patient panel on our portal and we direct message them. With the

COVID-19 pandemic we have been educating patients via the portal, website, new patient packets, and phone. We have implemented phone and video visits during this very trying time and will continue into the future. We are discussing ways to do a PFAC [Patient and Family Advisory Council] meeting via a Zoom platform. We are also working on a fall newsletter that will be pushed to the patient portal.”

Track 2, Greater Buffalo

Kimberly Kuznet (St. Luke’s University Health Network)• “We have done a ‘survey’ PFAC to our members due to the majority of the members being in

our ‘older’ population. Based on those survey results, we found we need to focus on our patient portal app. We have brochures that we are going to send to the PFAC members regarding our patient portal app as well as virtual visit brochures. We are hoping to get their feedback with qualitative input on what could be changed or improved.”

Track 1, Greater Philadelphia

Verda Weston (Utica Park Clinic Catoosa)• “Our social workers and diabetes educators are doing primarily televideo visits. We are getting

great feedback from patients on access to televideo support. We have also experienced a significant decrease in no-shows for these televideo visits.”

Track 2, Oklahoma

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Poll #1

What are you most interested in learning about today?(Select all that apply)

Betty Sanchez-Catanese, MD

Somerville, NJ

CPC+ Track 1

1,100 Patients

1 Provider

1 Clinical Staff

Allscripts

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Betty Sanchez-Catanese, MD

Hinman Family Medicine

Longmont, CO

CPC+ Track 2

3,000 Patients

2 Providers

5 Clinical Staff

Aprima

7

Mark Hinman, MD

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Access to Care

• Appointment reserved in schedule each hour for same-day or urgent visits

• Post-discharge patient education around access to care options and “right place at the right time” and “Call Us First”

• Collaborative agreement supports timely access to nearby behavioral health office

– Access to other specialties with collaborative agreements

• Care team accessibility to patients; strong phone line system

• Same-day sick appointments available as well as expanded hours (Mon–Fri open 7 a.m.)

• Consistent follow-up post ED and hospital visits within 72 hours to schedule follow-up visit as needed

• Dedicated appointment slots for physicals to reduce wait time

• 24/7 access to on call provider, posters throughout the practice with “Call Us First” messaging

• Access to behavioral health with support embedded in office 3–4 days per week

Hinman Family MedicineBetty Sanchez-Catanese, MD

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Adapting Access to Care

Hinman Family MedicineBetty Sanchez-Catanese, MD

• Established separate entrance at practice for sick visits to ensure continued access to care

– Maintained designated sick visit appointment types to ensure patient comfort in coming to the office

• Challenge shifting to telehealth with older population

• Patient education around COVID and vaccine safety

• Initially started telehealth using a new phone app then recently transitioned to the Aprima platform

– Audio and video capabilities– Continuing telehealth with those who have

respiratory concerns• House calls available for wellness visits

– Now targeted for patients who are elderly, high risk, or have transportation barriers

• Curbside labs, blood draws, and parking lot visits; curbside flu shots continue to be available

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Improving Access With Patient Engagement

Hinman Family MedicineBetty Sanchez-Catanese, MD

• PFAC feedback around telehealth implementation and “Call Us First” flyer

• Engage PFAC members via email and mail feedback when in-person wasn’t possible

• Working to improve patient experience with an app that consolidates all appointments across the care setting

– Will include as PFAC agenda item when available

• Shifted in-person PFAC meetings to a virtual Zoom platform

– Meet every 4–6 months with members• Feedback from 4–5 members around

covid response and support needs regarding safety and comfort level coming into the office

• Patient engagement valuable for improved phone line system and international normalized ratio (INR) process with in-house testing

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Poll #2

Based on the strategies shared, what would you like to hear more about? (Select all that apply)

Audience Q&A

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Resources

• CPC+ Timely Access to Care Resource List 1* and List 2*• Resources from the Institute for Healthcare Improvement (IHI)

– Backlog Reduction Worksheet– Third Next Available Appointment– Measure and Understand Supply and Demand

• Practice Snapshot: Optimizing COVID-19 Patient Care Via Telehealth*• Putting Group Visits Into Practice (Stoeckle Center)*

*NOTE: You need to be logged in to CPC+ Connect before clicking the link.

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Summary

• Remember these key takeaways:– Reserve time slots for same-day and urgent appointments, and educate patient population

on their opportunities to access the practice– Establish telehealth, curbside, and house-call options for patients to expand access to care– Use PFAC’s and general patient feedback to guide efforts to improve access to care

• Continue the conversation on CPC+ Connect• Review similar posters on the CPC+ Fall Virtual Summit website• Complete our short post-event evaluation

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Disclaimer

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: The information in this presentation has not been publicly disclosed and may be privileged and confidential. This document must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.

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