Patients are demanding better insights and transparency into their care. They want to be empowered in their decision-making through better information about everything from diagnoses and care plans to quality ratings and cost.
Providers and payers understand current market drivers creating the need for better patient experiences. In essence, higher engagement equates to lower costs. For this reason, many are implementing tools and strategies to elevate patient engagement for future positioning and sustainability.
Patient portals and digital forms of messaging are increasingly important to these strategies, although the complexities of clinical language and codified terminologies often present challenges to effective patient communication. That’s why strategies that improve the outlook on content comprehension are increasingly important to patient experience. Outlined below are three ways health plans, providers, and health IT vendors can keep communication with patients from getting lost in translation:
Improve translation of codified terminologies
A three-way disconnect exists in terms of how patients communicate with providers and health plans. Essentially, there is a gap in 1) the way providers describe a patient’s care; 2) the coding terminology required for clinical and billing purposes; and 3) the way patients talk about healthcare.
The reality is that patients do not view their care in terms of procedure and diagnosis codes or lab work. As such, providers need to translate claims and billing data into communication that is usable by patients. For instance, an ICD-10 code pulled from a lengthy payer bill may represent a chronic condition such as arthritis as M19.90 with a description, Unspecified osteoarthritis, unspecified site, forcing most patients to call the provider to understand the details. Thus, the language used for external communications such as explanation of benefits (EOBs), denial letters, and patient bills must be decoded into a patient-friendly format.
Create a consistent search experience for consumers
Specialty providers in competitive markets view patient engagement as a way to capture and convert online search traffic. To accomplish this, they’re investing a lot of money in search engine optimization (SEO), ads, and online education materials, with the goal of translating that traffic into appointments. Unfortunately, once they optimize SEO for heart failure, diabetes, and other chronic conditions, providers often discover gaps in their patient portal or online scheduling platform when attempting to translate that traffic to the appropriate specialist within the network.
Consider that many factors come into play when patients search for information about conditions or diagnoses, including cultural and regional influences as well as health literacy. While one patient may use the term “wheezing” to describe a symptom of asthma, another may search on “trouble breathing,” or use a less accurate description such as “choking.” In order for investments in search to be successful, the end-to-end search experience must overcome the dynamic nature of search terminology, and present the appropriate specialist or information to patients.
Increase the effectiveness of your care management teams with maps and content.
Ensuring the accuracy of the underlying code sets is critical when mobilizing care teams focused on supporting patients who are at risk for having expensive medical procedures or hospitalizations, or helping them avoid trips to the ER. With the recent revision of over 5,500 ICD-10 codes and close to 200 CPT® code changes projected to take effect Jan 1st of 2017, prevention and acute care programs need to ensure their population cohorts and code groups are capitalizing on these changes.
In addition to managing periodic code set updates, leveraging clinical data such as problem lists or lab results can also provide leading indicators for patients defined as “at risk.” When population cohorts are not properly defined to use the latest standards and updates for claims and clinical data, the effectiveness of a patient engagement effort may be undermined even before the conversation begins with a patient.
Elevating consumer content strategies
The right investment in terminology management infrastructure can provide the needed foundation to support a patient engagement strategy experiencing challenges in the areas outlined above. For example, the Health Language platform can automatically map and update disparate terminologies to improve the accuracy of your care management programs. For providers or payers looking to improve patient communication, our Consumer Friendly Descriptions cover over 100,000 codes for diagnoses and procedures, making it easier for patients to understand coverage, benefits and complex medical bills.
Speak to an expert to learn more about our Consumer Friendly Descriptions and Reference Data Management solution.
CPT® is a registered trademark of the American Medical Association (AMA).