“It was the best of times, it was the worst of times...it was the season of light, it was the season of darkness, it was the spring of hope, it was the winter of despair”. Although written over 160 years ago by Charles Dickens, this opening line to A Tale of Two Cities, could not be more applicable to the outcomes healthcare operators will face. Hope is not a strategy. Healthcare executives will be faced with tough decisions in the coming months. Making the right decisions just might avoid a winter of despair.
This has been a year of “firsts” for all of us. It’s the first time that students have returned to school on an iPad, grocery stores sported barren cleaning supply shelves, and now we are about to enter into a flu season during the middle of one of the worst public health crises in human history.
As a physician and health system executive for over 20 years, I’ve seen very little change in how patients seek and consume their healthcare. Patients have historically faced multiple barriers when trying to understand when, where and how to get their care. Lack of price transparency, network restrictions, and health insurance plans designed without the consumer in mind, have combined to make a trip to the doctor more like an evening at the casino. When you consider the above, and then add in COVID-19 patients seeking testing and care, and the perfect storm begins to brew.
But wait, there’s more...
The CDC estimates that the 2019-2020 flu season caused 410,000 hospitalizations, 18 million doctor visits, and at least 24,000 deaths. Although we accept flu as part of the human condition, looking at the numbers, our annual flu seasons are actually quite tragic; yet only 45 percent of Americans were vaccinated against the flu in 2019. It goes without saying, hospitalization is not a desired outcome. When you add COVD-19 and an average influenza season to the mix, resources will be tapped out early. With any recurrence of COVID-19, this could lead to catastrophic implications. Our hospitals could be overtaxed very easily.
While we don’t yet have a publicly approved COVID-19 vaccine, we do have an influenza vaccine available for this flu season which is safe and efficacious. Just under 200M doses of flu vaccine are being produced this year, far more than were administered last season. We can keep our communities safe by asking patients to get their flu shot every year. We know that the vaccine will not prevent everyone from contracting the flu, but we do know that it is very effective at preventing flu-related hospitalizations which is vital, especially this year. Patients don’t always realize that getting a flu shot can prevent them from being infected by influenza and COVID-10 concurrently. Concomitant influenza and COVID-19 infections in individuals are poorly understood. Many cases of co-infection were reported early in the year, but research into outcomes is scant.
What you can do to decrease the spread of flu this season
Providers need to keep beating the drum of social distancing and proper hand washing. Patients should be encouraged to wear masks. We need to add this sound advice, even more.
Encourage patients to get this season’s influenza vaccine early
While most consumers are aware that there is a flu vaccine available, many people remain hesitant to receive the vaccine due to long held false beliefs around vaccine safety. The data are clear, when properly screened for potential adverse reactions, it is safe to administer the influenza vaccine.
If patients are faced with the equivalent experience of a visit to the doctor in order to receive their vaccine, it is clear, we will not be successful in mass vaccination. We have to make it easy for them; scheduled days for ‘flu clinics’, directed outreach to your most vulnerable patients, coupling vaccinations with visits for other reasons. We need to do this now. Early vaccination will help as our system is relatively unburdened at this point.
During these unprecedented times, patients should know that vaccine manufacturers could face vaccine shortages like we’ve seen in previous years. This means that early vaccination against influenza is key. Side effects may be minimal, like soreness around the infection site, but a small tradeoff to keep patients out of a busy hospital concurrently treating patients who have tested positive for COVID-19.
Proactive outreach will be key. I suggest leveraging email campaigns and social media channels where you engage with patients to let them know that your flu shots are in, and patients should vaccinate early in the season to avoid potential shortages. Invest in local marketing channels to attract new patients to your practice for their flu shot. This is a great opportunity to attract new patients to your practice panel and engage them regarding their overall health and wellness. Many patients this year are forgoing primary and preventive care services, which means that they will be provider-agnostic when it comes to the flu shot when they can’t see their trusted general practitioner. Bottom line; don’t expect patients to actively seek out the flu vaccine this year on their own.
It’s important for your clinic front office staff, medical assistants, and providers to remind patients of the benefits of receiving an influenza vaccination this season so that they understand the value of a flu shot so that the investment in time feels worthwhile and important. A front office ‘script’ can be very effective in driving patients to receive their inoculation in conjunction with another reason for visit.
Implement a Contactless workflow
Many consumers are reluctant to seek elective health care services during the COVID-19 pandemic. We’ve certainly seen patient volumes increase in the last few months from the eerily empty waiting rooms of March and April, but flu and back-to-school season has historically been a busy time for most medical offices and the volumes have not resumed to pre-COVID-19 rates.
How do we get them back? When 60% of patients feel unsafe and/or unsure about being in a waiting room today, operators must take steps to reassure patients that seeking medical services is safe. Patients have spoken and they are loud and clear. They want to see contactless check-in through digital paperwork and consent forms, contactless payment processing, and the ability to avoid sitting in a crowded waiting room around other patients who may be more ill than they are.
It is imperative to prioritize the patient experience by giving patients peace of mind to utilize technology to replace paper, pen, and clipboards and reduce the number of communal surfaces and items that patients are interacting with during their visit. Patients are asking to be given the option to complete their paperwork digitally and remit it back to your staff for registration prior to their visit which includes their identification card, insurance card, payment method, intake forms, and consent forms to reduce wait times upon their arrival. Keep in mind, all these benefits are transferable to your employees as well. They will be safer also.
Consider making your parking lot your new waiting room. Patients can then check-in and wait in their car, then receive a phone call or SMS message to enter the waiting room and be escorted by a medical assistant to the exam room to begin the evaluation. This allows patients to spend minimal time around others to maintain social distancing, and avoids patients from crowding the front desk. Patients should also be able to track their spot in line so that they know when they should expect to receive a message that they’ll be seen next.
Utilize virtual visits
Not all patients need or want to receive care in-person, and for these instances, leveraging virtual visits is a great way to load-balance patient volumes to keep patients in the comfort of their home for their encounter when possible. Virtual visits are convenient because they don’t require driving in traffic, finding parking, or waiting endlessly. They allow patients not to save their paid time off, and instead squeeze in a quick virtual visit at a time that is convenient for them whether they are at home or traveling, right from their mobile phone, tablet or laptop.
Influenza is one of the most common conditions treated over a virtual visit because it is highly contagious and removes the potential for an infected patient to come into contact with others. Antivirals, if indicated, can be e-prescribed for the patient, and many local pharmacies now offer free deliveries for all prescriptions. It’s quick, convenient, and a delightful patient experience.
Virtual visits are also a great tool to leverage for triaging patients to assess symptoms and decide on next steps. Some patients may only need to rest at home, while others should be referred to a specialist, require a prescription, be seen in person, or may be advised to seek a COVID-19 test. Making it easy for patients to seek convenient care without ever having to leave their home allows them to rely less on Dr. Google, and more on experienced and qualified healthcare professionals for advice.
As healthcare professionals, we are obligated to look ahead and predict the storms we see forming. We need to open up the channels of patient centric communication and drive the healthcare we want our patient to have; the care they deserve.