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Convincing Patients Not to Delay Necessary In-Person Care During COVID-19: Top 5 Tips

Chad Anguilm, MBA, Vice President, In-Practice Technology Services, Medical Advantage, Part of the TDC Group of Companies

Updated December 7, 2020: Although the COVID-19 pandemic has spurred innovations throughout healthcare, many medical practices are wrestling with a stubborn trend: Due to anxiety about potentially contracting the virus, many patients are putting off in-person appointments. According to the Centers for Disease Control and Prevention (CDC), by June 30, 2020, an estimated 41 percent of U.S. adults had delayed or avoided medical care, including urgent/emergency care and routine care, because of concerns about COVID-19.

As patients’ fears intensify with the current surge in COVID-19 cases, many practices are presented with a three-fold problem: Patients not getting the care they need, a decline in revenue from in-person appointments, and potential liability risks presented by patients who experience adverse events because of a delayed diagnosis—the number one cause of medical malpractice suits.

Despite these challenges, practices nationwide have developed strategies to enable their in-person operations to remain safe for patients and profitable for the practice. In advising healthcare providers on operations during COVID-19, practice consultants from Medical Advantage, part of the TDC Group of companies (TDC Group), have compiled the following top five tips for encouraging patients to come in for necessary in-person visits during the pandemic:

  1. Educate patients about the dangers of ignoring critical health issues.
    Emphasize to patients that ignoring critical health issues can be more harmful than potentially being exposed to the COVID-19 virus, and that medical facilities can be some of the lowest risk places to visit during the pandemic due to strict sterilization. A recent study determined that 225,530 excess deaths (the gap between observed and expected deaths) occurred in the U.S. between March 21 and April 11, 2020. About two-thirds of these excess deaths were related to COVID-19, but the other third was the result of other conditions.

    The study further demonstrated that states with the highest death rates from COVID-19 also had the largest proportional increases in deaths from other underlying causes, including diabetes and cardiovascular disease. In other words, where the COVID-19 disruptions were largest, diminished access to medical care and/or fear that medical care would be dangerous in a COVID-19-intense environment were causing patients to not get care that they otherwise would be getting for diseases not related to COVID-19.

    Additionally, the National Cancer Institute predicts an excess of 10,000 deaths due to breast cancer and colorectal cancer because of missed screening in the year 2020.

    Therefore, patients with heart conditions—or even those experiencing symptoms of heart conditions—should not wait until their conditions worsen and potentially become life-threatening. The same can be said of patients with diabetes, those who find symptoms of cancer, those who need to participate in a regular cancer screening, those who experience certain infections, and those with other potentially serious conditions.
  2. Update safety practices, workflows, and precautions.
    A cornerstone of any strategy to encourage patients to come in for necessary visits during the COVID-19 pandemic is patient safety. Temperature and health questionnaire screenings, mask mandates, sanitation and social distancing policies, and PPE for staff are all familiar, excellent steps, but represent only the beginning of a cohesive patient safety plan that minimizes virus hazards and ensures patient peace of mind.

    One of the most effective ways to ensure patient safety is by focusing on patient triage. Patients who need COVID-19 tests can call or text from their cars, eliminating the need for them to be in the waiting room. Patients coming in for other issues can be screened on the phone and in the parking lot before directly entering the exam room.

    Other workflow adjustments can increase patient safety protections even further. For example, scheduling staff and patients strategically keeps the number of people in the clinic low, reducing the risk of virus transmission. In addition, staggering scheduling allows practices to dedicate their limited in-person resources to patients with priority needs, while using telehealth and other solutions for less at-risk populations. One idea is to have senior hours or at-risk hours, a dedicated one-to-two-hour block of appointments each morning for those most at risk.
  3. Bolster marketing efforts to communicate new COVID-19 measures to patients.
    Communicate patient safety policies clearly to patients. Whether you’re reaching patients in person, through your website, or via a phone or telehealth connection, being clear and transparent about the steps your practice is taking to offer safe care during the pandemic will boost patient peace of mind.

    On-site at your practice, this can mean signage inside and outside pointing out distancing and sanitation measures. Some practices have used color-coding systems to clearly signal to patients which areas, like exam rooms and waiting areas, have already been disinfected before their visit—and the schedule for cleaning. Patients coming into the practice in person represent an opportunity for practice staff and physicians to verbally communicate the new safety procedures, as well as create a sense of precaution by leading by example and adhering to patient safety practices during the appointment.

    Text, email, patient portal messaging, social media, and website campaigns are all places where you can educate and reassure patients about extra precautions your practice is taking.

    Showing and communicating with patients that their safety is being prioritized with protective, pandemic-adapted policies gives patients increased peace of mind, making them more likely to come in for any necessary in-person visits.
  4. Shore up patient outreach efforts to triage at-risk populations.
    By proactively targeting certain at-risk and chronic care management (CCM) populations, usually via phone, practices have successfully continued delivering these patients the in-person care they need, even during the pandemic.

    This means reaching out to patients who are older or have underlying conditions. Practices can utilize nurse telehealth appointments to triage patient needs and ensure CCM patients are following medical advice, diet recommendations, and taking medications as prescribed. In this way, providers can take care of all or most of the check-up remotely, and reserve in-person space for patients with priority needs.

    Create a strategy, have a plan, pick up the phone, and drive appointments. Many patients are spending their days at home and are more likely to pick up a call when they see that it is from their healthcare provider.
  5. Leverage telehealth to take the pressure off in-person operations.
    One dilemma medical practices face during the pandemic is how to enact social distancing policies while still providing patients the in-person care they need. For this reason, telehealth has become a critical tool for allowing healthcare providers to offer basic care remotely while freeing up appointment and office space for patients who need in-person care.

    Medicare and Medicaid compliance codes have been relaxed during the pandemic, allowing practices to deliver certain services via telehealth that had previously been reserved for in-person visits. Using telehealth services to bridge the gap while reserving in-person care for patients with priority needs is a crucial part of any plan to keep patients coming in for necessary visits during the pandemic.

The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.