AMA News Wire Apps, alerts and coffee power real-time patient care at Rush

As consumer expectation changes, health systems must adapt to the expectations of other industries.

Rush University System for Health in Chicago achieved this by developing digital capabilities around same-day access, wait time notifications, service recovery and immediate feedback from patients during clinical encounters. As a result, Rush has watched its patient experience improve, particularly related to delays in care.

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“At Rush, we’ve tried to put in some hard work to really be pragmatic about defining our digital transformation strategy,” Ben Wolfe, senior director of digital transformation at Rush University System for Health, said during a presentation at the inaugural AMA Insight Network Summit in Chicago.

Specifically, Rush is focused on three portfolios to solve real world problems: digital consumerism, digital care transformation and digital operations efficiency.

Rush University System for Health is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.

Consumerism focuses on growth, access, convenience and personalization—all those things a health system needs to survive and thrive in the future. The second pillar involves a rethinking of clinical care delivery—using digital tools to help patients get and stay healthy at home rather than the hospital and which help caregivers shed tedious administrative duties so they can spend more time with their patients.

The third portfolio is about using augmented intelligence (AI)—also known as artificial intelligence—and other automation tools to “help back office staff work more efficiently and to ensure that physicians have the resources they need to deliver the right care at the right time,” Wolfe explained.

Consumers want instant convenience Consumers want instant convenience

Wolfe’s talk focused on the first pillar, consumerism. Disruptors and experiences in other service industries are elevating patient expectations.

“Our patients are increasingly looking outside of health care,” he noted.

Industries like travel are offering more real-time conveniences. If you check into a hotel and don’t have a bathrobe, a simple text can deliver that item to you in less than five minutes.

“Those types of things are sticking in our heads and in our patients’ heads,” said Wolfe.

Ben Wolfe

The question is: Why can’t health care do those types of things?

“There’s no denying that patients are increasingly flocking to online telehealth companies because of their focus on delivering a more convenient experience,” Wolfe said. “They’re very accessible, and it’s easy to get what you want for a specific need or condition. But there’s also a risk to that convenience—sometimes they fail to take the whole person, their larger health care story and potential underlying causes into account, resulting in missed opportunities to improve long-term health and ensure they get the high quality, specialized care they need.”

Patients nevertheless “are increasingly using those services as the yardstick to measure us by as health systems,” he commented.

Access biggest “pain point” Access biggest “pain point”

Rush attempted to cut through the noise in this space by listening to its patients. It established an online focus group of over 20,000 Rush patients who wanted to have a voice in its future digital strategy. Many said their patient experience would improve if Rush tackled this access and convenience problem.

“Everyone knows access is a big pain point,” said Wolfe. “Operationally, it’s very difficult to solve. But Rush’s focus group made it clear that if health systems don’t tackle access, patients will find somebody who will, he cautioned.”

The Rush Connect System The Rush Connect System

To deliver on that commitment to hyper-convenient access, Rush created the “Rush Connect” platform, which offers virtual-first specialty, urgent and primary care services that make care available ASAP—often as soon as today or tomorrow. The platform also provides personalized alerts that help patients self-schedule important screenings and appointments in just a few taps from a text message.

“The goal is for patients to use these virtual tools to more efficiently interact with the health system, digitally or otherwise,” said Wolfe. “Rush Connect Virtual Specialty Care now encompasses eight medical specialties, treating 40 conditions in as little as 24 hours, and quickly triaging patients to in-person care as needed. To date more than 1,200 visits have gone through this program and early patient feedback and outcomes have been tremendous.”

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Paying attention to the ratings Paying attention to the ratings

To connect with patients, digital tools can be used to understand and anticipate their needs and solve those needs proactively. But patients can easily get turned off by technology, he continued. It’s critical that health systems maintain the human touch. Nobody wants to talk to a bot about a really sensitive issue.

“We want to make sure that we’re maintaining that personal moment,” said Wolfe.

One initiative that built on these insights is a program that nudges patients to rate their interactions with Rush at the moments that matter. The early focus has been on appointment scheduling and bill pay experiences. When patients complete these activities online, they get a text with a thumbs up or thumbs down icon that allows them to quickly let Rush know how it went, similar to a rating you might give a rideshare driver.

“And if you give us a thumbs down, that gets funneled to a real human for follow up,” said Wolfe. As an example, an agent gave prompt attention to a cancer patient who gave a thumbs down over a problem with scheduling a past-due appointment, helping to quickly keep their care on track.

“Patients have been amazed that, not only are we listening to their feedback, but that we’re proactively addressing their concerns—with a real human touch,” said Wolfe.

Rush Connect also offers appointment wait time alerts—with a caffeine fix perk.

Real-time wait-time predictions are sent to the patient via automated text messages. If a patient arrives at the clinic and their physician or other clinician is running substantially behind, clinic staff can also provide a QR code for free coffee at the Starbucks downstairs, with reassurances that they will be seen soon.

But it isn’t about getting free coffee. Patients “are delighted just to know where the provider is in their schedule. And we’re getting feedback that says: This is amazing. Thank you for respecting my time. Why isn’t every system doing this?” he said.

“The process took just a few months to set up, and the system has spent a negligible amount of money on coffee coupons. It was primarily an operational procedure, to train staff at the front desk on using the digital coupon system and integrating it into their existing customer service processes,” said Wolfe.

90% patient satisfaction 90% patient satisfaction

These small interventions have increased Rush’s satisfaction scores related to wait times from the 66th to the 91st percentile nationally. And over 90% of patients surveyed reported positive experiences with Rush’s digital service offerings.

“We’re moving the needle on access and patient satisfaction, and we’re also moving the needle on our growth objectives for the health system. It’s a win-win,” said Wolfe.

Looking forward, Rush plans to leverage digital tools for more acute use cases. Other uses include “up next” alerts in the emergency department and inpatient units, a “My Care Journey” view in the mobile app, real time hospital throughput predictions and interventions, and automated preauthorization and denials processing.