Delivering High-Quality Patient Care

As a Director of Patient Access and Capacity Management, Ann works closely with the clinical chairs and operational leaders throughout Nebraska Medicine’s access innovations division that supports ambulatory care. Her role is to ensure that optimal patient access strategies are developed, implemented, and sustained to support seamless patient service across the care continuum. Spending many years in this field, she has successfully led access-focused initiatives that create and support exceptional access services, performance, value, and experience for their patients and provider.

Could you please shed some light on how the access innovations division works?

Within our access innovations division, we have three contact centers. First is the ambulatory contact center that schedules across our ambulatory enterprise. Second, we have the radiology contact center that schedules our radiology and imaging services. Lastly, our medical communication center is an answering service that provides 24*7 nurse triage support.

Could you elaborate on the continuity of care you offer to the patient?

Considering continuity of care as our top priority, we work to keep our patients connected with their providers. Especially for our primary care, where we have recognized and certified the Patient-Centered Medical Home (PCMH) model. It keeps patients scheduled with their Primary Care Provider (PCP). For example, if a patient requests an acute appointment, our agents can use an algorithm to schedule it with the patient's PCP. In case PCPs are not available on the same day or within the timeframe based on the patient's acute need, we turn to our PCP's care team that we've built for each primary care practitioner. If they also don't have the availability, we look across the patient-centered medical home. By leveraging a feature called 'auto search,' our agents can check the availability of the entire PCMH across all 14 of our clinic locations. If there is no availability under any branch, agents can look within the patient-centered medical home region. The agent can confirm the availability and get the patient in with that . We ensure a patient access-centric model of care, that helps the patient align with their PCP. We also have a chronic care management team that connects patients with their PCP for situations like chronic diseases. It's important to have continuity of care to support their health and wellness journey.

What are the challenges you faced while getting patients to their PCPs?

Patients having both acute and chronic situations simultaneously is the major challenge. Especially when it is a chronic disease, and it is acutely worsening. In that situation, PCP is our priority. But if they are unavailable, our agents have another option of annual wellness visits to get a patient schedule with their PCP . Again, suppose there is no availability as per the patient's needs matches the time when the annual appointment needs to be scheduled . In that case, we send a message to the clinic to make some adjustments and look for other available options. We ensure that annual wellness visits to the center are always coordinated with the patient's PCP.

Have you seen any recent technological trends in the market lately during the post-pandemic?

We implemented a Customer Relationship Management (CRM) tool for our team during the pandemic time. The tool was Salesforce, and we leveraged it for various reasons. The main aim was to ensure that we provide a personalized patient experience and bring in all the information across our organization into that tool.

Could you please elaborate more on your CRM Platform?

For us, CRM works best in improving the patient experience and allowing them to access our great providers across Nebraska healthcare institutions. We feel that our contact center teams, patients, and families are integrated and connected with the CRM tool. The agent can access the patient card, which gives a 360-degree view of the patient information—their name, date of birth, address, and medical histories. The most important thing about the patient card is its primary language that helps agents determine the patient's language and take the conversation forward. As we have some refugees around the Nebraska medicine area who speak different languages, agents can easily identify and connect them with live interpretive services support. Hence, it's important to ensure that we follow our diversity, inclusion, support, and standards while uplifting all patients.

Another element of leveraging CRM tools is the 'knowledge article' we have created. It allows us to put in information that agent needs for every single specialty that we support. Additionally, the knowledge articles give very specific in-basket functionality. It's a key our agents can send in the message basket. We also have a nurse triage facility that allows us to give the highest degree of care for each patient's need and customization for each specialty.

Having 14 clinics in a different location sometimes becomes challenging for new patients. That's why we have a way-finder to guide patients on how they can reach the clinic. When the patient calls in, the agent quickly pulls that information up into Salesforce and pushes an email notification to the patient with the help of our marketing and communications team. The email includes guided actions for step-by-step directions to that specific clinic patient is looking for. In addition, it includes a hyperlink that takes them directly to Google maps.

Medication refill is another tool that we use. Any patient who needs to refill medication can request via patient portal reminder. We help them connect with the best pharmacy, and sometimes they do it themselves. For example, during the pandemic, many patients stated they couldn't refill medication until an updated visit with the provider as their prescriptions were post-dated or out of range. As a result, the drugs from our epic department may now be found in our Salesforce tool. The reason that we have this is our agents non-medical and inexperienced.

From an epic perspective, they do not have access to those medication refills, screens, or information. Having it surface in our Salesforce allows our team to have a clear conversation with the patient and gain better understanding of which medication they're asking to have refilled. Then, they send an in-basket message to that clinical team to proceed with the same request. This tool has been innovative in the space over the past years as it saves at workflow and process of least one to two nurses.

From a population health standpoint, we've partnered with the primary care and population health teams to provide information on health maintenance topics. Due to the pandemic, patients have put off health prevention , and we want to make sure that things like mammography do not fall behind. We feel that every interaction with our patients is an opportunity to intervene. Our marketing communication or population health teams will send a letter to their home if they are due or late for mammography. Then agents use a prepared script to talk to the patient about their health and get them scheduled. If the patient requests that the procedure be performed outside our organization, the agents will gather a few details and transmit them to our population health team. To be noted in the permanent medical record and close the healthcare gaps that are part of our value-based contract.

Overall, leveraging CRM has been a great success for us. It allows us to have detailed patient information and communication with our clinicians while ensuring that all areas of our relationship are data-driven.

Any piece of advice for the upcoming professionals in this field?

I would suggest three key points for young professionals to succeed: clarity, alignment, and focus. They should have clarity about their objectives and strive for constant progress. And to align the entire team with those goals that help them achieve high performance. That also goes hand in hand with focus. It is vitally important to have them focused on their mission and vision. For us, our mission is to lead the world in transforming patient access through premier services, extraordinary patient care, collaboration, and innovation. In addition, we seek to be a trusted partner so that our providers can be confident in our services, communications, assessments, and recommendations. All these elements are extremely valuable to succeeding in patient access and exceeding in healthcare.