Ambulatory Surgery Centers (ASC) make life a lot easier for many patients who need procedures that do not require an overnight hospital stay. ASCs often have facilities and resources designed specifically to deliver quick and safe same-day procedures versus inpatient services. ASCs reduce healthcare costs as well—with a 25% to 75% reduction in overall cost for most operations performed in what is considered an outpatient rather than inpatient setting. In the United States, over 5,300 ASCs in the United States perform 23 million surgeries every year. But ASC efficiency and effectiveness can be compromised by appointment cancellations. It’s critical for ASCs to maintain consistent communication with patients in order to ensure procedures proceed smoothly and that they reschedule appointments when possible, avoiding cancellations—which can be costly to any surgical facility.
Surgery cancellations can be expensive. One study found that cancelled elective outpatient surgeries at a New Orleans medical center – for just one year – cost the medical center nearly $1 million. In many cases, surgeries get cancelled due to a misunderstanding between the patient and the center—patients may not have the tests requested by the surgeon or anesthetist – OR they may not understand the need to have an empty stomach prior to the procedure and disregard warning to not drink or eat past a specific time. They may also fail to complete pre-admission administrative formalities, believing these can be handled at the time of the procedure – which for most surgeries cannot.
It’s easy to see how cancellations can happen. The amount of information provided to the patient can be overwhelming. Don’t eat or drink after midnight, make sure you have a ride home after your procedure, bring a list of all medication you’re currently taking, avoid alcohol for 12 hours in advance, stop taking this medication 3 days prior, come 2 days prior for pre-admission clearance, don’t wear lotion…the list goes on and on. It is simply too easy for patients to forget and for the surgery to be cancelled. In fact, estimates show that on average patients only retain between 10-25% of the information shared by a physician and one study found that almost half the information the patients actually remembered was incorrect so it is a wonder that any surgery takes place. So, what can be done to address this?
Ongoing communication between the ASC and patient is key to addressing these issues. However, ASCs may not have time to make phone calls and patients have been shown not to respond to phone and voice mail. Text messaging is one intervention that has shown positive results in terms of medication adherence and appointment attendance. ASC’s can leverage text messaging in order to ensure patients receive instructions, are reminded on a regular basis, and adhere to the plan they need to follow in order to have a successful procedure that proceeds as planned. Considering how attached most people are to their phone (99% of text messages are opened and 90% are read within three minutes of receipt) it makes sense to provide the information through a channel that most patients are comfortable with and will pay close attention to—far more efficient than providing patients with an information sheet that typically get shoved in a purse or backpack and forgotten about as the procedure nears.
But while text messaging can be helpful in terms of sharing information it also has its limitations. Typical text messaging is not HIPAA compliant, so PHI cannot be shared through it. What is necessary here is a means of communication that replicates the look and feel of SMS and is HIPAA compliant AND that can be set up to send an automated series of texts for patient engagement to help remind patients of important information. One option to pursue is a secure messaging and engagement platform such as Vaporstream which allows ASC staff to communicate with patients via messaging without compromising security or privacy of information. Key to the Vaporstream platform is the ability for staff to automate messages—so ongoing communication with patients do not take a significant chunk out of the staff’s day. By using secure messaging to communicate with patients in real-time – just when the patient needs information- to remind them of medications, appointments and other surgical instructions, ASCs can help reduce cancellations and help ensure that procedures proceed smoothly—maintaining efficiency and safety for themselves and their patients. Utilizing this same approach, ASCs can help decrease readmissions as well with an open communication with the patient to send post-surgical communications and surveys – improving the patient experience and ensuring that patients have the information they need when they need it.
Contributor: Kristi Perdue Hinkle